Doctor Name: | MISS MILDRED MAGSANOC |
NPI Number: | 1346443785 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 40QAOO730900 |
Business Practice Address: | 114 Hayes Mill Rd Atco, NJ - 080042457 |
Business Phone Number: | 8568097242 |
Business Fax Number: | |
Mailing Address: | 26 Brookstone Dr, SICKLERVILLE |
State: | NJ |
Postal Code: | 080811692 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251G0304X |
License Number: | 40QAOO730900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Geriatrics |
Taxonomy Definition: |