Provider Demographics
NPI:1033224464
Name:MOGLIA, ANN W (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:W
Last Name:MOGLIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DOWNING ST
Mailing Address - Street 2:1P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4734
Mailing Address - Country:US
Mailing Address - Phone:212-924-7227
Mailing Address - Fax:
Practice Address - Street 1:10 DOWNING ST
Practice Address - Street 2:SUITE 1P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4734
Practice Address - Country:US
Practice Address - Phone:212-924-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007160-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY220581OtherMHN PROVIDER
NY00746709Medicaid
NY0069783OtherGHI PROVIDER
NYP595674OtherOXFORD PROVIDER
NY220581OtherMHN PROVIDER