Individual
MS. COLLEEN SONDRA MAGAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.P.A.-C
Contact information
Practice address
1104 LOGTOWN RD, FULTONVILLE, NY 12072-2642
(518) 922-8000
Mailing address
2209 GENESEE ST, UTICA, NY 13501-5930
(315) 801-3282
(315) 801-8391
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007669
NY
363A00000X
Physician Assistant
007669-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02743277
—
NY
Enumeration date
05/24/2006
Last updated
10/24/2019
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