Provider Demographics
NPI:1679752307
Name:POTHEMONT, MARGARITA (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:
Last Name:POTHEMONT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARK LN
Mailing Address - Street 2:APT. 1G
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3451
Mailing Address - Country:US
Mailing Address - Phone:914-699-5274
Mailing Address - Fax:
Practice Address - Street 1:1545 INWOOD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2001
Practice Address - Country:US
Practice Address - Phone:718-299-5500
Practice Address - Fax:718-299-1420
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY395324163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care