Provider Demographics
NPI:1730336694
Name:INTERRANTE, MARGARET MARY
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARY
Last Name:INTERRANTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:TOMCZAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1750 GLENN LANE
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422
Mailing Address - Country:US
Mailing Address - Phone:215-619-7475
Mailing Address - Fax:215-619-7180
Practice Address - Street 1:1144 LOCUST STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6797
Practice Address - Country:US
Practice Address - Phone:215-542-0430
Practice Address - Fax:215-351-5595
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP003446G363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner