Provider Demographics
NPI:1255634572
Name:LITTLE, MARY A (RPAC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:A
Last Name:LITTLE
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Gender:F
Credentials:RPAC
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Mailing Address - Street 1:50 E 34TH ST
Mailing Address - Street 2:ROOM 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4319
Mailing Address - Country:US
Mailing Address - Phone:212-340-7792
Mailing Address - Fax:212-340-7858
Practice Address - Street 1:50 E 34TH ST
Practice Address - Street 2:ROOM 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4319
Practice Address - Country:US
Practice Address - Phone:212-340-7792
Practice Address - Fax:212-340-7858
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY002983363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant