MICKI N LY (NPI# 1346299435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346299435 |
| Entity Type | Individual |
| Full Name | MICKI N LY |
| Credential | M.D. |
| Practice Address |
89 Hookele St Suite 101 Kahului HI 96732-3513 |
| Mailing Address |
Po Box 3010 Kahului HI 96733-3010 |
| Practice Telephone | 8088776526 |
| Practice Fax Number | 8088716701 |
| Mailing Telephone | 8088776526 |
| Mailing Fax Number | 8088716701 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD 12031 | HI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | 508161 | 05 |
| Street Address |
89 HOOKELE ST SUITE 101 |
| City | KAHULUI |
| State | HI |
| Zip Code | 96732-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467884536 | Aloha Dermatology and Laser Center LLC | Dermatology | 89 Hookele St, 101, Kahului, HI 96732-3532 | 2013-07-31 |
| 1982925301 | Nicole L Dusenbury | Physician Assistant | 89 Hookele St, #103, Kahului, HI 96732-3532 | 2010-06-21 |
| 1306055967 | Melanie Bilbaeno Vallejos | Dentist | 89 Hookele St, Suite 203, Kahului, HI 96732-3513 | 2007-05-21 |
| 1134222151 | James E Muto | Internal Medicine | 89 Hookele St, #103, Kahului, HI 96732-3532 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134749435 | Catherine Phan | Behavior Technician | 427 Ala Makani St, Suite 200, Kahului, HI 96732 | 2020-04-16 |
| 1427535665 | Miles H. Katahara, D.d.s., Inc. | Dentist | 140 Hoohana St. Suite 204, Kahului, HI 96732 | 2018-07-20 |
| 1013428291 | Maui Family Young Men's Christian Association | Health Educator | 250 Kanaloa Ave, Kahului, HI 96732 | 2017-10-16 |
| 1467998765 | Costco | Clinic/Center | 540 Haleakala Highway, Kahului, HI 96732 | 2017-01-10 |
| 1164884649 | Arc of Maui County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 450a Kanaloa Street, Kahului, HI 96732 | 2016-03-24 |
| 1487016846 | Arc of Maui County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 450 B Kanaloa Avenue, Kahului, HI 96732 | 2016-03-24 |
| 1396118311 | Allison Yoshimoto | Speech-Language Pathologist | 122 Anamuli Street, Kahului, HI 96732 | 2015-11-13 |
| 1609252295 | Nanc Ellen Fellerman (-yahr) | Speech-Language Pathologist | 161 S. Wakea Avenue, Imua Family Services, Kahului, HI 96732 | 2015-08-05 |
| 1134508716 | Bayada Home Care | Community/Behavioral Health | 427 Ala Makani Street, Suite 200, Kahului, HI 96732 | 2015-05-28 |
| 1467843656 | B.c.p., Inc. Dba/ Bayada Home Health Care | Home Health | 427 Ala Makani St., Suite 200, Kahului, HI 96732 | 2015-02-10 |
| Find all providers in zip 96732 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134238173 | Joseph R Mckinlay Md LLC | Dermatology | 1003 Bishop St, Pauahi Tower, Suite #380, Honolulu, HI 96813-3429 | 2006-08-30 |
| 1992759211 | Alex Samuel Carcamo | Dermatology | 100 Kahelu Ave Ste 226, Mililani, HI 96789-3962 | 2006-05-20 |
| 1396968160 | Milton Ackerman, M.d., Inc. | Dermatology | 1150 S King St, Suite 201, Honolulu, HI 96814-1922 | 2007-04-10 |
| 1225069990 | Milton J Ackerman | Dermatology | 1150 S King St, Suite 201, Honolulu, HI 96814-1922 | 2006-07-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.