Provider Demographics
NPI:1295012821
Name:MORANDA, MAGDALENA JOANNA (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MAGDALENA
Middle Name:JOANNA
Last Name:MORANDA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ORANGE CT
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4411
Mailing Address - Country:US
Mailing Address - Phone:917-496-3396
Mailing Address - Fax:
Practice Address - Street 1:7 ORANGE CT
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4411
Practice Address - Country:US
Practice Address - Phone:917-496-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006060-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant