Individual
COLETTE MIGNOGNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
902 VISTA ON THE LAKE, CARMEL, NY 10512
(631) 455-1378
Mailing address
902 VISTA ON THE LK, CARMEL, NY 10512-4616
(631) 455-1378
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
014701-1
NY
Other
Enumeration date
08/06/2017
Last updated
07/21/2022
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