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General NPI Number Information
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NPI Number | 1164649570
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Entity Type | Individual
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Provider Name | TARA ANN MUGLIA L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 1492 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2319
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Country | US
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Telephone | 917-770-9757
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Fax |
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Provider Business Mailing Address
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Address Line | 426 N RAILROAD AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-4145
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Country | US
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Telephone | 718-370-2084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 071069-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 077025-1
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License Number State | NY
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