Individual
MARGE E SHALLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
1302 E MAIN ST, ENDICOTT, NY 13760
(607) 754-7171
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790
(607) 770-0025
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0039241
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02149080
—
NY
Enumeration date
04/18/2006
Last updated
07/08/2007
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