1003052440 NPI number — MRS. MARGARET E MAMMES REGISTERED NURSE CER

Table of content: MRS. MARGARET E MAMMES REGISTERED NURSE CER (NPI 1003052440)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003052440 NPI number — MRS. MARGARET E MAMMES REGISTERED NURSE CER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAMMES
Provider First Name:
MARGARET
Provider Middle Name:
E
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE CER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003052440
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
163 BEACH 112TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKAWAY PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11694
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-634-8351
Provider Business Mailing Address Fax Number:
718-634-8351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 EAST GATE BLVD.
Provider Second Line Business Practice Location Address:
SUITE 101B MARIAN CARE INC
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-471-8600
Provider Business Practice Location Address Fax Number:
516-408-3111
Provider Enumeration Date:
01/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  445808-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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