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NPI Code Detail

MEDICARE: MARYJOYCE MAMANGON PT

MEDICARE: MARYJOYCE MAMANGON PT
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
1225100000XPhysical Therapist0218421NY
2225100000XPhysical Therapist021842-1NY

General Provider Information

NPI Number : 1952319212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYJOYCE MAMANGON PT
Provider Business Mailing Address
First Line : 390 E SADDLE RIVER RD
Second Line :
City : UPPER SADDLE RIVER
State : NJ
Zip : 07458-1757
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 260 N LITTLE TOR RD
Second Line :
City : NEW CITY
State : NY
Zip : 10956-2627
Country : US
Telephone Number : 845-708-2000
Fax Number : 845-634-7731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 06/09/2025

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Directions to “ MARYJOYCE MAMANGON PT” Practice Location

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