Individual
KERRY MOGAVERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
(516) 378-2000
Mailing address
2 LOTUS LN, WESTBURY, NY 11590-6321
(516) 996-0704
(516) 377-2098
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0054791
NY
Other
Enumeration date
09/20/2019
Last updated
06/10/2021
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