Individual
ELLEN M. MCGRANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
317 S MANNING BLVD STE 220, ALBANY, NY 12208-1739
(518) 525-6418
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005585
NY
363AM0700X
Medical Physician Assistant
005585
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02502972
—
NY
01
—
P01053063
RAILROAD MEDICARE
NY
Enumeration date
08/11/2005
Last updated
11/13/2024
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