Provider Demographics
NPI:1962747378
Name:DILIBERTO, MARGARET M (MS ANP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:DILIBERTO
Suffix:
Gender:F
Credentials:MS ANP
Other - Prefix:
Other - First Name:MEG
Other - Middle Name:
Other - Last Name:DILIBERTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS ANP
Mailing Address - Street 1:101 SAINT ANDREWS LN
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2254
Mailing Address - Country:US
Mailing Address - Phone:516-674-7936
Mailing Address - Fax:516-674-7905
Practice Address - Street 1:101 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2254
Practice Address - Country:US
Practice Address - Phone:516-674-7936
Practice Address - Fax:516-674-7905
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306252-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health