Provider Demographics
NPI:1194245571
Name:AGNGARAYNGAY, ROBIN BRAYANT PUGAL (PTA)
Entity type:Individual
Prefix:MR
First Name:ROBIN BRAYANT
Middle Name:PUGAL
Last Name:AGNGARAYNGAY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:ROBIN BRAYANT
Other - Middle Name:PUGAL
Other - Last Name:AGNGARAYNGAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:961 ROBELLO LN # 337
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4546
Mailing Address - Country:US
Mailing Address - Phone:808-670-4313
Mailing Address - Fax:
Practice Address - Street 1:2230 LILIHA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1646
Practice Address - Country:US
Practice Address - Phone:808-547-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI343225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant