Provider Demographics
NPI:1356433254
Name:WILSON, MARGARET MCGRAW (MS RD CDE CNSD)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MCGRAW
Last Name:WILSON
Suffix:
Gender:F
Credentials:MS RD CDE CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HOLLAND AVE (120)
Mailing Address - Street 2:STRATTON VA MEDICAL CENTER
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3410
Mailing Address - Country:US
Mailing Address - Phone:518-626-6889
Mailing Address - Fax:518-626-5678
Practice Address - Street 1:113 HOLLAND AVE
Practice Address - Street 2:STRATTON VA MEDICAL CENTER
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3410
Practice Address - Country:US
Practice Address - Phone:518-626-6889
Practice Address - Fax:518-626-5678
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY608-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP93562Medicare UPIN