Provider Demographics
NPI:1619301108
Name:WHITE, MARGIE (ANP)
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 ROCKLEDGE RD APT 22D
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-5311
Mailing Address - Country:US
Mailing Address - Phone:302-399-6601
Mailing Address - Fax:
Practice Address - Street 1:57 ROCKLEDGE RD APT 22D
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-5311
Practice Address - Country:US
Practice Address - Phone:302-399-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302825-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner