Provider Demographics
NPI:1053285171
Name:WASILEWSKI, MARGARET MARY
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:WASILEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GLEASON ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2222
Mailing Address - Country:US
Mailing Address - Phone:781-996-9240
Mailing Address - Fax:
Practice Address - Street 1:67 OLD KINGS HWY
Practice Address - Street 2:
Practice Address - City:OGUNQUIT
Practice Address - State:ME
Practice Address - Zip Code:03907-3133
Practice Address - Country:US
Practice Address - Phone:781-996-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD23161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty