Provider Demographics
NPI:1588296297
Name:CUFAUDE, CARISSA DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:DAWN
Last Name:CUFAUDE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GREENSIDE WAY S STE 1
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-6706
Mailing Address - Country:US
Mailing Address - Phone:508-210-5890
Mailing Address - Fax:
Practice Address - Street 1:440 W JUBAL EARLY DR STE 240
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6319
Practice Address - Country:US
Practice Address - Phone:540-450-2706
Practice Address - Fax:540-450-2741
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant