Provider Demographics
NPI:1790871937
Name:VANDERLIN, MARGARET (APRN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:VANDERLIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 MIDDLESEX TPKE
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1317
Mailing Address - Country:US
Mailing Address - Phone:860-395-0111
Mailing Address - Fax:860-395-1264
Practice Address - Street 1:841 MIDDLESEX TPKE
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1317
Practice Address - Country:US
Practice Address - Phone:860-395-0111
Practice Address - Fax:860-395-1264
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001322163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult