Provider Demographics
NPI:1568885101
Name:DAVE C. DINEROS, PHYSICAL THERAPIST,P.C.
Entity Type:Organization
Organization Name:DAVE C. DINEROS, PHYSICAL THERAPIST,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DINEROS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-357-4237
Mailing Address - Street 1:1328 146TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2434
Mailing Address - Country:US
Mailing Address - Phone:718-357-4237
Mailing Address - Fax:
Practice Address - Street 1:7 RONALD AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2105
Practice Address - Country:US
Practice Address - Phone:917-640-6106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017669251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health