Provider Demographics
NPI:1659443943
Name:FRASER, MARGARET CAMERON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:CAMERON
Last Name:FRASER
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 1:35 RIVERSIDE TER
Mailing Address - Street 2:
Mailing Address - City:BLAUVELT
Mailing Address - State:NY
Mailing Address - Zip Code:10913-1622
Mailing Address - Country:US
Mailing Address - Phone:201-444-6844
Mailing Address - Fax:
Practice Address - Street 1:65 N MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3233
Practice Address - Country:US
Practice Address - Phone:201-444-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA059590002084P0800X
NY1863762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF38189Medicare UPIN
NJ098173Medicare PIN