Provider Demographics
NPI:1821051921
Name:MCMANUS, MARIA ALBA (RPAC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ALBA
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:RPAC
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Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-209-5090
Mailing Address - Fax:
Practice Address - Street 1:815 HALLOCK AVE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1244
Practice Address - Country:US
Practice Address - Phone:631-929-0325
Practice Address - Fax:631-929-0360
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY002224363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant