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NPI Code Detail

MEDICARE: GLENN DOMINGO CALUBAQUIB

MEDICARE: GLENN DOMINGO CALUBAQUIB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist030439NY

General Provider Information

NPI Number : 1699093815
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN DOMINGO CALUBAQUIB
Provider Business Mailing Address
First Line : 8024 138TH ST
Second Line :
City : BRIARWOOD
State : NY
Zip : 11435-1034
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2955 BRIGHTON 4TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-8533
Country : US
Telephone Number : 718-834-8202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2010
Last Update Date : 05/12/2010

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Directions to “ GLENN DOMINGO CALUBAQUIB ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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