Provider Demographics
NPI:1750974390
Name:THERAPEUTIC POTENTIAL INC
Entity type:Organization
Organization Name:THERAPEUTIC POTENTIAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALDWIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALAMIONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-376-8989
Mailing Address - Street 1:3234 60TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2028
Mailing Address - Country:US
Mailing Address - Phone:917-376-8989
Mailing Address - Fax:806-552-9573
Practice Address - Street 1:5801 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3437
Practice Address - Country:US
Practice Address - Phone:347-208-9573
Practice Address - Fax:806-552-9573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1588961221OtherNPI