Individual
BRENDAN CIAMPA CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
(207) 773-1489
Mailing address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
(207) 773-1489
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-08302
NC
363A00000X
Physician Assistant
017848
NY
363A00000X
Physician Assistant
PA2842
ME
363AS0400X
Surgical Physician Assistant
Primary
PA2842
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017848
NYS PHYSICIAN ASSISTANT LICENSE
NY
Enumeration date
08/07/2014
Last updated
02/05/2026
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