Provider Demographics
NPI:1609029537
Name:NORTH SHORE PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:NORTH SHORE PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RONGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-276-3141
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-0394
Mailing Address - Country:US
Mailing Address - Phone:808-276-3141
Mailing Address - Fax:888-808-3141
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI607882OtherSUMMERLIN
HI00A0213858OtherHMSA
HI00A0213858OtherHMSA