Provider Demographics
NPI:1457680084
Name:DALMACY, MARGARETTE
Entity Type:Individual
Prefix:
First Name:MARGARETTE
Middle Name:
Last Name:DALMACY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGARETTE
Other - Middle Name:
Other - Last Name:DALMACY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4305 SNYDER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-4109
Mailing Address - Country:US
Mailing Address - Phone:718-826-0411
Mailing Address - Fax:
Practice Address - Street 1:4305 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-4109
Practice Address - Country:US
Practice Address - Phone:718-826-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY582080-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02386450Medicaid