Individual
CARL CHRISTIAN MANGURALI SUICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 E 56TH ST, NEW YORK, NY 10022-3607
(212) 759-2211
Mailing address
31 E 32ND ST FL 4, NEW YORK, NY 10016-5595
(212) 759-2282
(212) 379-2123
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
044194
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044194
STATE LICENSE
NY
Enumeration date
12/05/2019
Last updated
02/23/2023
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