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General NPI Number Information
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NPI Number | 1467633040
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Entity Type | Organization
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Legal Business Name | HOPE PHYSICAL MEDICINE & REHABILITATION, PC
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Dates
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Enumeration Date | 11/24/2007
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 5123 QUEENS BLVD
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City | WOODSIDE
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State | NY
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Zip | 11377-4587
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Country | US
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Telephone | 718-458-5333
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Fax | 718-458-5335
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Provider Business Mailing Address
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Address Line | 894 OAKS DR
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-1936
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Country | US
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Telephone | 516-270-2755
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Fax | 516-270-2755
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANTE ACEBO CUBANGBANG
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Credential | M.D.
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Telephone | 516-270-2755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 60-061044
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License Number State | NY
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