Provider Demographics
NPI:1710297718
Name:LONDONO, MAGALI (RNC MSN PNP)
Entity Type:Individual
Prefix:
First Name:MAGALI
Middle Name:
Last Name:LONDONO
Suffix:
Gender:F
Credentials:RNC MSN PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LEGION AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-3943
Mailing Address - Country:US
Mailing Address - Phone:203-870-4824
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-6371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-09
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382002363LA2100X
NY525288163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WP0200XNursing Service ProvidersRegistered NursePediatrics