Provider Demographics
NPI:1801328018
Name:MAGURNO, JAMES III (ATC STUDENT; EMT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MAGURNO
Suffix:III
Gender:M
Credentials:ATC STUDENT; EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 W COLLEGE AVE
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:536 W COLLEGE AVE
Practice Address - Street 2:APARTMENT 5
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3725
Practice Address - Country:US
Practice Address - Phone:570-423-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program