Provider Demographics
NPI:1063272672
Name:MAGOVERN, MARGARET ANN (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:MAGOVERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 95TH ST APT 21G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4071
Mailing Address - Country:US
Mailing Address - Phone:908-370-6950
Mailing Address - Fax:
Practice Address - Street 1:21 MANOR HILL RD
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2429
Practice Address - Country:US
Practice Address - Phone:908-370-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program