Kavanagh, Patricia L

Kavanagh, Patricia L is an individual health care provider with primary practice located at 850 Harrison Ave Yacc5, Boston MA 02118-4001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kavanagh, Patricia L can be contacted via phone (617) 414-5946.

Contact Information

Primary practice address
850 Harrison Ave Yacc5 Boston MA 02118-4001
Fax: (617) 414-4541
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 229930 Massachusetts

Profile Details

NPI number 1619909140
LBN Legal business name Kavanagh, Patricia L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Dec 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619909140 NPPES
Massachusetts MEDICAID 110073939A

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