Provider Demographics
NPI:1366857864
Name:MACRI-PAULY, MARGERY JO (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARGERY
Middle Name:JO
Last Name:MACRI-PAULY
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 1:225 DARLA DR
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-9361
Mailing Address - Country:US
Mailing Address - Phone:585-752-2291
Mailing Address - Fax:
Practice Address - Street 1:225 DARLA DR
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-9361
Practice Address - Country:US
Practice Address - Phone:585-752-2291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228903-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse