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General NPI Number Information
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NPI Number | 1568885101
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Entity Type | Organization
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Legal Business Name | DAVE C. DINEROS, PHYSICAL THERAPIST,P.C.
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 7 RONALD AVE
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City | HICKSVILLE
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State | NY
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Zip | 11801-2105
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Country | US
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Telephone | 917-640-6106
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Fax |
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Provider Business Mailing Address
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Address Line | 1328 146TH ST
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City | WHITESTONE
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State | NY
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Zip | 11357-2434
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Country | US
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Telephone | 718-357-4237
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. DAVE DINEROS
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Credential | DPT
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Telephone | 718-357-4237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 017669
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License Number State | NY
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