Mildred Magsanoc, PT

Individual provider Active NPI Geriatric Physical Therapist · Atco, NJ

NPI 1346443785 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346443785
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Physical Therapist 2251G0304X
License
40QAOO730900 (NJ)
Practice address
114 Hayes Mill Rd
Atco, NJ 08004-2457
Phone
(856) 809-7242
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
40QAOO730900NJMDGeriatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 40QAOO730900 NJ Yes

Addresses

Primary practice location

114 Hayes Mill Rd
Atco, NJ 08004-2457

Mailing address

26 Brookstone Dr
Sicklerville, NJ 08081-1692

Other providers in Atco, NJ

All providers in Atco, NJ · Geriatric Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.