Provider Demographics
NPI:1427330984
Name:DANTE, REX DANTE PALIJO (PT)
Entity type:Individual
Prefix:
First Name:REX DANTE
Middle Name:PALIJO
Last Name:DANTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 80TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4716
Mailing Address - Country:US
Mailing Address - Phone:347-238-7208
Mailing Address - Fax:
Practice Address - Street 1:8853 53RD AVE FL 2
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4517
Practice Address - Country:US
Practice Address - Phone:347-238-7208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030603-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030603OtherLICENSE NUMBER