Provider Demographics
NPI:1093915795
Name:AKLAND, AMY BRAY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BRAY
Last Name:AKLAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:VIRGINIA
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 MAIN ST G6
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1992
Mailing Address - Country:US
Mailing Address - Phone:781-729-4878
Mailing Address - Fax:781-729-5989
Practice Address - Street 1:1101 BEACON ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-731-2390
Practice Address - Fax:617-731-1283
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAP2334363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical