Individual
JASON ANDREW MOGUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
249 CHURCHILL RD, TEANECK, NJ 07666-3009
(201) 837-1552
Mailing address
249 CHURCHILL RD, TEANECK, NJ 07666-3009
(201) 837-1552
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
012851-1
NY
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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