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General NPI Number Information
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NPI Number | 1891191037
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Entity Type | Individual
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Provider Name | MAGAN REEDY GRIGG PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 105 CANAL LANDING BLVD STE 1
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City | ROCHESTER
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State | NY
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Zip | 14626-5107
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Country | US
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Telephone | 585-368-4050
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Fax |
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Provider Business Mailing Address
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Address Line | 100 KINGS HWY S
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City | ROCHESTER
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State | NY
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Zip | 14617-5504
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0005377
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-05292
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7921
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2198
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA.0005377
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License Number State | CO
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Taxonomy #6
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-05292
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2198
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License Number State | SC
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Taxonomy #8
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 031893
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License Number State | NY
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