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NPI Code Detail

MEDICARE: ELLEN M. MCGRANN PA

MEDICARE:   ELLEN M. MCGRANN  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant005585NY
2363A00000XPhysician Assistant005585NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01053063OTHERNYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780686691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN M. MCGRANN PA
Provider Business Mailing Address
First Line : PO BOX 14890
Second Line :
City : ALBANY
State : NY
Zip : 12212-4890
Country : US
Telephone Number : 518-525-5634
Fax Number :
Provider Business Practice Location Address
First Line : 317 S MANNING BLVD STE 220
Second Line :
City : ALBANY
State : NY
Zip : 12208-1739
Country : US
Telephone Number : 518-525-6418
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 11/13/2024

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Directions to “ ELLEN M. MCGRANN PA” Practice Location

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