Provider Demographics
NPI:1992901565
Name:ROSEN, MERI ANGELA (DC)
Entity type:Individual
Prefix:DR
First Name:MERI
Middle Name:ANGELA
Last Name:ROSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 KEKONA PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-9027
Mailing Address - Country:US
Mailing Address - Phone:808-572-6940
Mailing Address - Fax:
Practice Address - Street 1:81 MAKAWAO AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8895
Practice Address - Country:US
Practice Address - Phone:808-573-4776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
A06574-6OtherHMSA PROVIDER NUMBER
A06574-6OtherHMSA PROVIDER NUMBER
HI52572Medicare ID - Type Unspecified