Individual
DR. THADDEUS RONALD MOGILNICKI
Active
Individual
DR. THADDEUS RONALD MOGILNICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
912
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000030825
BOSTON MEDICAL HEALTH NET
MA
05
—
1895532
—
MA
01
—
213380
NEIGHBORHOOD HEALTH GROUP
MA
01
—
2168630
CIGNA GROUP
MA
01
—
311299
MHN
MA
01
—
468604
TUFTS
MA
01
—
497004
VAUE OPTIONS
MA
01
—
M19000
BC BS HMO GROUP
MA
01
—
W01662
BC BS INDEMNITY
MA
Enumeration date
11/06/2006
Last updated
07/08/2007
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