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NPI 1720244312

NPI 1720244312 : CYNTHIA ANNE MANGAN M.A., P.T. : OCEANSIDE, NY

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General NPI Number Information
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    NPI Number           |    1720244312
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    Entity Type          |    Individual 
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    Provider Name        |    CYNTHIA ANNE MANGAN M.A., P.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/02/2008
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    Last Update Date     |    10/31/2020
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Provider Practice Location Address
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    Address Line         |    3941 BEA CT 
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    City                 |    OCEANSIDE
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    State                |    NY
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    Zip                  |    11572-5907
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    Country              |    US
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    Telephone            |    516-317-9375
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    Fax                  |    516-764-5323
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Provider Business Mailing Address
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    Address Line         |    3941 BEA CT 
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    City                 |    OCEANSIDE
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    State                |    NY
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    Zip                  |    11572-5907
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    Country              |    US
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    Telephone            |    516-317-9375
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    Fax                  |    516-764-5323
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    014987-1
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    License Number State |    NY
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