Provider Demographics
NPI:1538442116
Name:TONKERY, MARYBETH (RN)
Entity type:Individual
Prefix:MRS
First Name:MARYBETH
Middle Name:
Last Name:TONKERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MARYBETH
Other - Middle Name:
Other - Last Name:TONKERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:131 LONGVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14487-9773
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8528 MAIN ST
Practice Address - Street 2:
Practice Address - City:HONEOYE
Practice Address - State:NY
Practice Address - Zip Code:14471-9637
Practice Address - Country:US
Practice Address - Phone:585-229-5171
Practice Address - Fax:585-229-5160
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY505481163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool