Basic Information
| Provider Information | |||||||||
| NPI: | 1144493206 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCARTHY | ||||||||
| FirstName: | KRISTINA | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 INDUSTRIAL RD STE 5 | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017573736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084731480 | ||||||||
| FaxNumber: | 6175625415 | ||||||||
| Practice Location | |||||||||
| Address1: | 440 E CENTRAL ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020381374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083212850 | ||||||||
| FaxNumber: | 5083840066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2008 | ||||||||
| LastUpdateDate: | 10/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1622 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.