Provider Demographics
NPI:1366654683
Name:ANGELES, DOGIE RECABAR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:DOGIE
Middle Name:RECABAR
Last Name:ANGELES
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3508
Mailing Address - Country:US
Mailing Address - Phone:201-218-2208
Mailing Address - Fax:201-385-5074
Practice Address - Street 1:65 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4634
Practice Address - Country:US
Practice Address - Phone:201-286-2114
Practice Address - Fax:201-385-5074
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY028114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ2233Medicare PIN