Provider Demographics
NPI:1447343132
Name:MAKIYA, ROBERT DAMIEN (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAMIEN
Last Name:MAKIYA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 ALIIKOA STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821
Mailing Address - Country:US
Mailing Address - Phone:808-732-4288
Mailing Address - Fax:808-732-4288
Practice Address - Street 1:4603 ALIIKOA STREET
Practice Address - Street 2:(WORKS FROM PATIENT'S HOME)
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821
Practice Address - Country:US
Practice Address - Phone:808-732-4288
Practice Address - Fax:808-732-4288
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 1930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C00224588OtherHMSA (BC/BS)
HIH57284Medicare ID - Type Unspecified