Provider Demographics
NPI:1437481967
Name:METZGER, MARY JANE (RN CDE)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:METZGER
Suffix:
Gender:F
Credentials:RN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RUDOLPH TER
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1528
Mailing Address - Country:US
Mailing Address - Phone:914-423-7125
Mailing Address - Fax:
Practice Address - Street 1:17 RUDOLPH TER
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1528
Practice Address - Country:US
Practice Address - Phone:914-423-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204769163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator