Provider Demographics
NPI:1760858260
Name:MAGNER, DEVORA (RN)
Entity Type:Individual
Prefix:
First Name:DEVORA
Middle Name:
Last Name:MAGNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEVORA
Other - Middle Name:
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:380 LENOX AVE
Mailing Address - Street 2:APT 9J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-2381
Mailing Address - Country:US
Mailing Address - Phone:917-623-8684
Mailing Address - Fax:
Practice Address - Street 1:380 LENOX AVE
Practice Address - Street 2:APT 9J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-2381
Practice Address - Country:US
Practice Address - Phone:917-623-8684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY665571163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse