Provider Demographics
NPI:1306361852
Name:VEGA, MARIA MARGARITA
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:MARGARITA
Last Name:VEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:14136-1446
Mailing Address - Country:US
Mailing Address - Phone:716-467-4144
Mailing Address - Fax:
Practice Address - Street 1:75 MAIN ST
Practice Address - Street 2:
Practice Address - City:SILVER CREEK
Practice Address - State:NY
Practice Address - Zip Code:14136-1446
Practice Address - Country:US
Practice Address - Phone:716-467-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-06
Last Update Date:2017-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317387-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse