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NPI Code Detail

MEDICARE: SERYL MINGOA PTA

MEDICARE: SERYL MINGOA PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant008280NY

General Provider Information

NPI Number : 1578945465
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERYL MINGOA PTA
Provider Business Mailing Address
First Line : 620 REISS PL APT 2E
Second Line :
City : BRONX
State : NY
Zip : 10467-8049
Country : US
Telephone Number : 347-406-1188
Fax Number :
Provider Business Practice Location Address
First Line : 729 PELHAM PKWY N
Second Line :
City : BRONX
State : NY
Zip : 10467-9506
Country : US
Telephone Number : 718-944-5050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2015
Last Update Date : 06/26/2015

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Directions to “ SERYL MINGOA PTA” Practice Location

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