Provider Demographics
NPI:1659232247
Name:MAUGHAN, WILLIAM BRENDAN III (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRENDAN
Last Name:MAUGHAN
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:61 NOTTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1737
Mailing Address - Country:US
Mailing Address - Phone:516-279-7914
Mailing Address - Fax:
Practice Address - Street 1:1000 N VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1000
Practice Address - Country:US
Practice Address - Phone:516-705-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-21
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY034713363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant