Provider Demographics
NPI:1093051294
Name:VANDERPUTTEN, MARGARET ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:VANDERPUTTEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 CHATHAM DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-1402
Mailing Address - Country:US
Mailing Address - Phone:631-563-6309
Mailing Address - Fax:
Practice Address - Street 1:84 CHATHAM DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1402
Practice Address - Country:US
Practice Address - Phone:631-563-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299427-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse