Provider Demographics
NPI: | 1992857874 |
---|---|
Name: | HEMATOLOGY ONCOLOGY ASSOCIATES, INC |
Entity type: | Organization |
Organization Name: | HEMATOLOGY ONCOLOGY ASSOCIATES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | NIRANJAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RAJDEV |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 808-969-7856 |
Mailing Address - Street 1: | 126 PUUHONU WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | HILO |
Mailing Address - State: | HI |
Mailing Address - Zip Code: | 96720-2067 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 126 PUUHONU WAY |
Practice Address - Street 2: | |
Practice Address - City: | HILO |
Practice Address - State: | HI |
Practice Address - Zip Code: | 96720-2067 |
Practice Address - Country: | US |
Practice Address - Phone: | 808-969-7856 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-18 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
HI | 2612 | 207RH0003X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Single Specialty |