Provider Demographics
NPI:1225503535
Name:CORBETT, MAURA KATHLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:KATHLEEN
Last Name:CORBETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:K
Other - Last Name:DESHARNAIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:123 MARSDALE CT
Mailing Address - Street 2:
Mailing Address - City:SELKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:12158-9703
Mailing Address - Country:US
Mailing Address - Phone:518-221-8740
Mailing Address - Fax:
Practice Address - Street 1:43 NEW SCOTLAND AVE MC-139
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3478
Practice Address - Country:US
Practice Address - Phone:518-262-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant