Provider Demographics
NPI:1407251697
Name:ACHIEVEABLE OT, P.C.
Entity Type:Organization
Organization Name:ACHIEVEABLE OT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNGCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-357-1620
Mailing Address - Street 1:4223 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE LL107
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2575
Mailing Address - Country:US
Mailing Address - Phone:718-357-1620
Mailing Address - Fax:718-799-5520
Practice Address - Street 1:4223 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE LL107
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2575
Practice Address - Country:US
Practice Address - Phone:718-357-1620
Practice Address - Fax:718-799-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09272261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center