Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD-3643 | HI |
NPI | 1013006659 |
---|---|
Provider Name | Dr. Jay L. Grekin |
First Address | Honolulu, HI 96813-3009 |
Second Address | Honolulu, HI 96813-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 14/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D36131 | (02) | HI |