Healthcare Provider Details

I. General information

NPI: 1811681539
Provider Name (Legal Business Name): MARGRET WENTWORTH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGRET BROWER FNP

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5856 SCENIC AVE
MEXICO NY
13114-3012
US

IV. Provider business mailing address

61 DELANO ST
PULASKI NY
13142-1400
US

V. Phone/Fax

Practice location:
  • Phone: 315-963-4133
  • Fax: 315-963-4960
Mailing address:
  • Phone: 315-298-6564
  • Fax: 315-298-7831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number352000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: