Healthcare Provider Details

I. General information

NPI: 1518099787
Provider Name (Legal Business Name): MARGARETHA CHRISTINE HERTLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 FIREMENS WAY
POUGHKEEPSIE NY
12603-6519
US

IV. Provider business mailing address

1320 ROUTE 217
GHENT NY
12075
US

V. Phone/Fax

Practice location:
  • Phone: 845-452-9220
  • Fax:
Mailing address:
  • Phone: 518-672-7448
  • Fax: 518-672-5433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2077871
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: