Individual
MARY BRAGOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 E MONTAUK HWY, HAMPTON BAYS, NY 11946-1816
(631) 723-3362
Mailing address
7 OCEAN AVE, HAMPTON BAYS, NY 11946-2322
(631) 723-3362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8150
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249145
—
NY
Enumeration date
04/03/2007
Last updated
07/08/2007
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