Provider Demographics
NPI:1053353722
Name:RONGE, SABINE (PT)
Entity type:Individual
Prefix:MRS
First Name:SABINE
Middle Name:
Last Name:RONGE
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 1:135 HAUMANA RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-9304
Mailing Address - Country:US
Mailing Address - Phone:808-276-3141
Mailing Address - Fax:808-572-8696
Practice Address - Street 1:135 HAUMANA RD
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-9304
Practice Address - Country:US
Practice Address - Phone:808-276-3141
Practice Address - Fax:808-572-8696
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0213858OtherHMSA
HIAV234ZMedicare PIN