Provider Demographics
NPI:1306527486
Name:ABARENTOS, OSCAR DIMACULANGAN
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:DIMACULANGAN
Last Name:ABARENTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64-01 55 AVAENUE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1623
Mailing Address - Country:US
Mailing Address - Phone:347-237-7058
Mailing Address - Fax:
Practice Address - Street 1:64-01 55 AVAENUE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1623
Practice Address - Country:US
Practice Address - Phone:347-237-7058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550779163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse