Individual
MRS. MARY JUDE MOGAVERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 BIRDSONG PKWY, ORCHARD PARK, NY 14127-3069
(716) 445-1073
Mailing address
15 BIRDSONG PKWY, ORCHARD PARK, NY 14127-3069
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/29/2008
Last updated
08/29/2008
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