Provider Demographics
NPI:1477756799
Name:MCGRAIL, MARIA LAURA (RPA-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LAURA
Last Name:MCGRAIL
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:LUZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:2066 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3916
Mailing Address - Country:US
Mailing Address - Phone:718-982-9001
Mailing Address - Fax:718-982-9008
Practice Address - Street 1:2066 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3916
Practice Address - Country:US
Practice Address - Phone:718-982-9001
Practice Address - Fax:718-982-9008
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02889527Medicaid
NYA400034147Medicare PIN