Provider Demographics
NPI:1063746584
Name:MOGAKA, GEORGE
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:MOGAKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LENAPE DR
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-8743
Mailing Address - Country:US
Mailing Address - Phone:484-898-0263
Mailing Address - Fax:
Practice Address - Street 1:24 LENAPE DR
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-8743
Practice Address - Country:US
Practice Address - Phone:484-898-0263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator