Provider Demographics
NPI:1821255589
Name:MOGELOF, DEBORAH ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANNE
Last Name:MOGELOF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BREEZY KNLS
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-1201
Mailing Address - Country:US
Mailing Address - Phone:203-293-4803
Mailing Address - Fax:
Practice Address - Street 1:5 BREEZY KNLS
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-1201
Practice Address - Country:US
Practice Address - Phone:203-293-4803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046539207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine