Most Relevant Information
Provider Data
| NPI Number: | 1003026246 |
| Provider Name: | ROBERT F. MOGOLLON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/23/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
124 WEBSTER ST
MERRICK
NY
115662617
Practice Location Phone/Fax
| Phone: | 5169936337 |
| Fax: |
Provider Mailing Location
17 W MERRICK RD
FREEPORT
NY
115203826
Provider Mailing Phone/Fax
| Phone: | 5163782992 |
| Fax: |