Provider Demographics
NPI:1730805243
Name:MOGLIA, JOCELYN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:
Last Name:MOGLIA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WATKINS GLEN
Mailing Address - State:NY
Mailing Address - Zip Code:14891-1627
Mailing Address - Country:US
Mailing Address - Phone:607-535-4629
Mailing Address - Fax:
Practice Address - Street 1:612 S DECATUR ST
Practice Address - Street 2:
Practice Address - City:WATKINS GLEN
Practice Address - State:NY
Practice Address - Zip Code:14891-1698
Practice Address - Country:US
Practice Address - Phone:607-535-3250
Practice Address - Fax:607-535-3285
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY455891163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool