Provider Demographics
NPI:1518099787
Name:HERTLE, MARGARETHA CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:MARGARETHA
Middle Name:CHRISTINE
Last Name:HERTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 ROUTE 217
Mailing Address - Street 2:
Mailing Address - City:GHENT
Mailing Address - State:NY
Mailing Address - Zip Code:12075
Mailing Address - Country:US
Mailing Address - Phone:518-672-7448
Mailing Address - Fax:518-672-5433
Practice Address - Street 1:76 FIREMENS WAY
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-6519
Practice Address - Country:US
Practice Address - Phone:845-452-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2077871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine