Provider Demographics
NPI:1902472111
Name:BYRNES, PAIGE JEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:JEAN
Last Name:BYRNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 E BERKELEY ST APT 624
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2952
Mailing Address - Country:US
Mailing Address - Phone:407-968-0599
Mailing Address - Fax:
Practice Address - Street 1:266 E BERKELEY ST APT 624
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2952
Practice Address - Country:US
Practice Address - Phone:407-968-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty