Provider Demographics
NPI:1225318868
Name:FOX, MARGARET ELISE (ATC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELISE
Last Name:FOX
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:ELISE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:114 LOOKOUT CIR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13209-9661
Mailing Address - Country:US
Mailing Address - Phone:315-414-6797
Mailing Address - Fax:
Practice Address - Street 1:791 W GENESEE STREET RD
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-9377
Practice Address - Country:US
Practice Address - Phone:315-685-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2000007545174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist