Provider Demographics
NPI:1225056609
Name:GARLAND, MAGGIE N (RPA-C)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:N
Last Name:GARLAND
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:N
Other - Last Name:PRIOLETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:5823 WIDEWATERS PKWY STE 4
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-3081
Mailing Address - Country:US
Mailing Address - Phone:315-500-7546
Mailing Address - Fax:315-378-4210
Practice Address - Street 1:5823 WIDEWATERS PKWY STE 4
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-3081
Practice Address - Country:US
Practice Address - Phone:315-500-7546
Practice Address - Fax:315-378-4210
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010599363A00000X, 363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400008228Medicare UPIN