Individual
MRS. MALLORY PAGELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 GOLF LN, MEDFORD, NY 11763-1254
(631) 882-2074
Mailing address
137 GOLF LN, MEDFORD, NY 11763-1254
(631) 882-2074
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008686-1
NY
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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