Provider Demographics
NPI:1871310904
Name:MOGELINSKI, KRISTIN (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MOGELINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W JOHNSON ST APT 6
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-1942
Mailing Address - Country:US
Mailing Address - Phone:410-279-3029
Mailing Address - Fax:
Practice Address - Street 1:10 W JOHNSON ST APT 6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-1942
Practice Address - Country:US
Practice Address - Phone:410-279-3029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant