Healthcare Provider Details

I. General information

NPI: 1790909091
Provider Name (Legal Business Name): MARGARET ANN TOLGE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MAIN ST SUITE 1
PORTER ME
04068-3527
US

IV. Provider business mailing address

161 S SHORE RD
NORTHVILLE NY
12134-5912
US

V. Phone/Fax

Practice location:
  • Phone: 207-625-8126
  • Fax: 207-625-7820
Mailing address:
  • Phone: 603-731-5237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF347549
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: