Healthcare Provider Details

I. General information

NPI: 1639903479
Provider Name (Legal Business Name): MARGARET DE BELLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 05/31/2026
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NORTH RD
POUGHKEEPSIE NY
12601-1328
US

IV. Provider business mailing address

102 FULTON AVE
POUGHKEEPSIE NY
12603-2857
US

V. Phone/Fax

Practice location:
  • Phone: 845-452-2728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1689553
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: