Provider Demographics
NPI:1548377948
Name:SILAN, CAROLYN JEAN (PT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JEAN
Last Name:SILAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68-1873 PANIOLO PL
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5222
Mailing Address - Country:US
Mailing Address - Phone:808-938-7084
Mailing Address - Fax:808-731-6997
Practice Address - Street 1:68-1873 PANIOLO PL
Practice Address - Street 2:
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738-5222
Practice Address - Country:US
Practice Address - Phone:808-289-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3610225100000X
CAPT24163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT241630Medicare UPIN