Provider Demographics
NPI:1841467453
Name:DECICCO TAGLIAGAMBE, MARGARETANN (PNP)
Entity type:Individual
Prefix:MRS
First Name:MARGARETANN
Middle Name:
Last Name:DECICCO TAGLIAGAMBE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MRS
Other - First Name:MARGARETANN
Other - Middle Name:
Other - Last Name:TAGLIAGAMBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PNP
Mailing Address - Street 1:20 HOSPITAL OVAL W
Mailing Address - Street 2:CEDARWOOD HALL WIHD CHILD ADVOCACY CENTER
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1559
Mailing Address - Country:US
Mailing Address - Phone:914-493-5333
Mailing Address - Fax:914-493-1984
Practice Address - Street 1:20 HOSPITAL OVAL W
Practice Address - Street 2:CEDARWOOD HALL WIHD CHILD ADVOCACY CENTER
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1559
Practice Address - Country:US
Practice Address - Phone:914-493-5333
Practice Address - Fax:914-493-1984
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381710363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics