Provider Demographics
NPI:1124436506
Name:MAYER, MARGARET (NP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MAYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CARRIAGE DR APT 3
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1832
Mailing Address - Country:US
Mailing Address - Phone:716-803-5088
Mailing Address - Fax:
Practice Address - Street 1:30 CARRIAGE DR APT 3
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1832
Practice Address - Country:US
Practice Address - Phone:716-803-5088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR220990363LF0000X
MARN187857363LF0000X
NYF338738-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily