Provider Demographics
NPI:1205006806
Name:LARRY F. SINE, PH.D., INC.
Entity type:Organization
Organization Name:LARRY F. SINE, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:SINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-531-1232
Mailing Address - Street 1:700 RICHARDS ST
Mailing Address - Street 2:SUITE 1502
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4605
Mailing Address - Country:US
Mailing Address - Phone:808-531-1232
Mailing Address - Fax:808-523-9375
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:SUITE 2705
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3301
Practice Address - Country:US
Practice Address - Phone:808-531-1232
Practice Address - Fax:808-523-9375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-293103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01651001Medicaid
HIPSY293OtherMDX/QUEENS
HI01651001OtherALOHA CARE
HIA1767-1OtherKAISER
HIA1767-1OtherTRICARE
HIA1767-1OtherHMSA
HIA1767-1OtherHMSA
HIR18042Medicare UPIN