Healthcare Provider Details

I. General information

NPI: 1235337163
Provider Name (Legal Business Name): MARGARITA M KUGLER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 WHEATLEY RD
GLEN HEAD NY
11545-2641
US

IV. Provider business mailing address

339 PINE ST
FREEPORT NY
11520-3141
US

V. Phone/Fax

Practice location:
  • Phone: 516-626-1000
  • Fax: 516-626-2039
Mailing address:
  • Phone: 516-379-5671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number050530-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: