Provider Demographics
NPI:1619034113
Name:MARGOLIS, BATSHEVA (RN)
Entity Type:Individual
Prefix:
First Name:BATSHEVA
Middle Name:
Last Name:MARGOLIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BATSHEVA
Other - Middle Name:
Other - Last Name:GRIMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:340 MULRY LANE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559
Mailing Address - Country:US
Mailing Address - Phone:718-845-2620
Mailing Address - Fax:718-845-9380
Practice Address - Street 1:108-19 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420
Practice Address - Country:US
Practice Address - Phone:718-845-2620
Practice Address - Fax:718-845-9380
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYOO412092163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00412092Medicaid