Provider Demographics
NPI:1154440899
Name:SUMAGUE, REIGNER MALOLES (PT)
Entity type:Individual
Prefix:
First Name:REIGNER
Middle Name:MALOLES
Last Name:SUMAGUE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 BARNHILL RD
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-4415
Mailing Address - Country:US
Mailing Address - Phone:215-534-7729
Mailing Address - Fax:
Practice Address - Street 1:224 BARNHILL RD
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-4415
Practice Address - Country:US
Practice Address - Phone:215-534-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2012-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist