Individual
MS. ELAINE S MOGOLLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6 OHIO DR, SUITE 202, NEW HYDE PARK, NY 11042-1129
(718) 281-8949
(516) 302-8657
Mailing address
6 OHIO DR, SUITE 202, NEW HYDE PARK, NY 11042-1129
(718) 281-8949
(516) 302-8657
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
016726-1
NY
Other
Enumeration date
04/13/2009
Last updated
04/13/2009
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