Basic Information
| Provider Information | |||||||||
| NPI: | 1720640337 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KINAMI | ||||||||
| FirstName: | HIROO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3959 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100321559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123050914 | ||||||||
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| Practice Location | |||||||||
| Address1: | CSB 424, MSC 613, 96 JONATHAN LUCAS STREET | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294250001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437923145 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2019 | ||||||||
| LastUpdateDate: | 01/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0202X | LL82973 | SC | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2086S0120X | 307463 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery |
No ID Information.