Provider Demographics
NPI:1205822178
Name:FLECK, MARGARET M (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:FLECK
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 1:21 LAFAYETTE RD
Mailing Address - Street 2:STE C
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3565
Mailing Address - Country:US
Mailing Address - Phone:973-729-0291
Mailing Address - Fax:973-729-6487
Practice Address - Street 1:110 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8043
Practice Address - Country:US
Practice Address - Phone:732-932-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07743300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8534403Medicaid
NJ048045Medicare ID - Type Unspecified
P32588Medicare UPIN