Provider Demographics
NPI:1760195945
Name:AMPAC, OMAL BIHAG JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:OMAL
Middle Name:BIHAG
Last Name:AMPAC
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6865 FRESH POND RD FL 2
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5263
Mailing Address - Country:US
Mailing Address - Phone:347-484-9004
Mailing Address - Fax:
Practice Address - Street 1:9208 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2107
Practice Address - Country:US
Practice Address - Phone:347-484-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist