Provider Demographics
NPI:1174916670
Name:MANGOOS PHYSICAL THERAPY P.C
Entity type:Organization
Organization Name:MANGOOS PHYSICAL THERAPY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KRISTIAN TRANGIA
Authorized Official - Last Name:MANGUBAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-450-3242
Mailing Address - Street 1:903 SHERIDAN AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-3304
Mailing Address - Country:US
Mailing Address - Phone:718-450-3242
Mailing Address - Fax:718-450-3217
Practice Address - Street 1:903 SHERIDAN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3304
Practice Address - Country:US
Practice Address - Phone:718-450-3242
Practice Address - Fax:718-450-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029005174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty