Individual
MRS. MARY TERESA SOMOGYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
625 S 4TH AVE, MOUNT VERNON, NY 10550-4919
(914) 483-9896
Mailing address
204 PARKSIDE DRIVE, SUFFERN, USA 10901
(914) 483-9896
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0039111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039111
LICENSE NUMBER
—
Enumeration date
10/25/2016
Last updated
10/25/2016
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