Provider Demographics
NPI:1144493206
Name:MCCARTHY, KRISTINA E (PA)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:E
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:617-562-5415
Practice Address - Street 1:440 E CENTRAL ST STE 102
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1374
Practice Address - Country:US
Practice Address - Phone:508-321-2850
Practice Address - Fax:508-384-0066
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1622363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant