Provider Demographics
NPI:1679642938
Name:ANDERSEN, MARGARET M (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:ANDERSEN
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 1:465 COLUMBUS AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1336
Mailing Address - Country:US
Mailing Address - Phone:914-769-1600
Mailing Address - Fax:914-769-1610
Practice Address - Street 1:465 COLUMBUS AVE STE 370
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1336
Practice Address - Country:US
Practice Address - Phone:914-769-1600
Practice Address - Fax:914-769-1610
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01749233Medicaid
NY23N711Medicare PIN
NY01749233Medicaid