Provider Demographics
NPI:1649949819
Name:KELLOGG, MARGARET S (LMT)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:S
Last Name:KELLOGG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HAVEN AVE APT 6H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5372
Mailing Address - Country:US
Mailing Address - Phone:845-248-9888
Mailing Address - Fax:
Practice Address - Street 1:217 HAVEN AVE APT 6H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5372
Practice Address - Country:US
Practice Address - Phone:845-248-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018486-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty