Provider Demographics
NPI:1669562781
Name:MCMANUS, MAIREE ELIZABETH (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:MAIREE
Middle Name:ELIZABETH
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:4254 MONTEZUMA CRSE
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-6855
Mailing Address - Country:US
Mailing Address - Phone:315-558-3199
Mailing Address - Fax:
Practice Address - Street 1:4900 BROAD RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-2265
Practice Address - Country:US
Practice Address - Phone:315-492-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2010-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY010099363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant