Provider Demographics
NPI:1962578476
Name:HERNANDEZ, ANTHONY CADIENTE (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CADIENTE
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 DILLINGHAM BLVD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4019
Mailing Address - Country:US
Mailing Address - Phone:808-848-1515
Mailing Address - Fax:808-847-2043
Practice Address - Street 1:1824 DILLINGHAM BLVD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4019
Practice Address - Country:US
Practice Address - Phone:808-848-1515
Practice Address - Fax:808-847-2043
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5996174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI029644-01Medicaid
HIB3303-1OtherHMSA
HI029644-01Medicaid
HID36333Medicare UPIN