Provider Demographics
NPI:1528216819
Name:BROGAN, MARGARET (OT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:BROGAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1025
Mailing Address - Street 2:
Mailing Address - City:REMSENBURG
Mailing Address - State:NY
Mailing Address - Zip Code:11960-1025
Mailing Address - Country:US
Mailing Address - Phone:631-325-6963
Mailing Address - Fax:
Practice Address - Street 1:340 MILL ROAD
Practice Address - Street 2:WESTHAMPTON BEACH U.F.S.D.
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978
Practice Address - Country:US
Practice Address - Phone:631-288-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013296225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics