Provider Demographics
NPI:1427140714
Name:MUGURUZA, MARGARITA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:MUGURUZA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 11 AGUILAR AVE
Mailing Address - Street 2:SUITE P3
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367
Mailing Address - Country:US
Mailing Address - Phone:718-380-4750
Mailing Address - Fax:718-380-4597
Practice Address - Street 1:156 11 AGUILAR AVE
Practice Address - Street 2:SUITE P3
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367
Practice Address - Country:US
Practice Address - Phone:718-380-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG400022368Medicare PIN