Healthcare Provider Details

I. General information

NPI: 1699774372
Provider Name (Legal Business Name): MARGARET A MANGANO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 MYRTLE ST SUITE 100
SARATOGA SPRINGS NY
12866-1044
US

IV. Provider business mailing address

59 MYRTLE ST SUITE 100
SARATOGA SPRINGS NY
12866-1044
US

V. Phone/Fax

Practice location:
  • Phone: 518-587-2400
  • Fax: 518-581-0141
Mailing address:
  • Phone: 518-587-2400
  • Fax: 518-581-0141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000155-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: