Provider Demographics
NPI:1437303294
Name:MANGIONE, ELIZABETH ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MANGIONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:MANGIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1 SKYLINE DR
Mailing Address - Street 2:SUITE 298
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2157
Mailing Address - Country:US
Mailing Address - Phone:914-347-5990
Mailing Address - Fax:914-347-5236
Practice Address - Street 1:1 SKYLINE DR
Practice Address - Street 2:SUITE 298
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2157
Practice Address - Country:US
Practice Address - Phone:914-347-5990
Practice Address - Fax:914-347-5236
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012101-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics