Provider Demographics
NPI:1740533009
Name:VOGEL, MARY SUE (SPECIAL EDUCATION TE)
Entity type:Individual
Prefix:MRS
First Name:MARY SUE
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION TE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CHESTNUT ST
Mailing Address - Street 2:P.O. BOX 311
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063
Practice Address - Country:US
Practice Address - Phone:716-672-2731
Practice Address - Fax:716-672-2739
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist