Provider Demographics
NPI:1962433888
Name:KISSENBERGER, ROBERT F (DPT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:KISSENBERGER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5147
Mailing Address - Country:US
Mailing Address - Phone:808-955-8339
Mailing Address - Fax:808-955-9808
Practice Address - Street 1:600 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5147
Practice Address - Country:US
Practice Address - Phone:808-955-8339
Practice Address - Fax:808-955-9808
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI8948485OtherQUEEN'S HEALTHCARE
HI51762502Medicaid
HI89085OtherKAISER PERMANENTE
HIH54378Medicare PIN