Provider Demographics
NPI:1588810279
Name:BERKHOUT, MARGARET MARY (RN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:BERKHOUT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 NEWPORT BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1570
Mailing Address - Country:US
Mailing Address - Phone:631-909-8378
Mailing Address - Fax:
Practice Address - Street 1:1036 WEST MONTAUK HWAY
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-4003
Practice Address - Country:US
Practice Address - Phone:631-728-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3310481163WC1500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health