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General NPI Number Information
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NPI Number | 1881433837
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Entity Type | Individual
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Provider Name | MA TAWNY ALEGRIA MOJICA
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Gender | Female
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 4405 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10040-4014
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Country | US
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Telephone | 646-779-8265
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Fax |
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Provider Business Mailing Address
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Address Line | 8330 VIETOR AVE APT 722
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City | ELMHURST
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State | NY
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Zip | 11373-3269
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Country | US
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Telephone | 929-366-9818
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 012885
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License Number State | NY
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