Organization Active NPI

United Wellness Medical, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Flushing, NY
National Provider Identifier
1114100773
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
234017 Issued in NY
Legal business name
UNITED WELLNESS MEDICAL, P.C.
Practice address
3910 Main St
Suite 303
Flushing, NY 11354-5403
Phone
(718) 461-5900
Fax
(718) 461-4833
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dante Acebo Cubangbang, M.D.
Title
President
Phone
(718) 461-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 234017 NY Primary

Addresses

Primary practice location

3910 Main St
Suite 303
Flushing, NY 11354-5403

Mailing address

3910 Main St
Suite 303
Flushing, NY 11354-5403
Phone (718) 461-5900

Other identifiers 1

IdentifierTypeStateIssuer
02623398MedicaidNY

National Provider Directory

National Provider Directory

Locations

3910 Main St
Ste 303
Flushing, NY 11354
Phone (718) 461-5900

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1114100773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 MAIN ST",
            "address_2": "SUITE 303",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545403",
            "telephone_number": "718-461-5900",
            "fax_number": "718-461-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 MAIN ST",
            "address_2": "SUITE 303",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545403",
            "telephone_number": "718-461-5900",
            "fax_number": "718-461-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED WELLNESS MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "CUBANGBANG",
        "authorized_official_first_name": "DANTE",
        "authorized_official_middle_name": "ACEBO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-461-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "234017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02623398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.