Wynne, Kathryn E.

Wynne, Kathryn E. is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wynne, Kathryn E. can be contacted via phone (774) 442-3713.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Fax: (774) 443-7989
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 262384 Massachusetts

Profile Details

NPI number 1619239050
LBN Legal business name Wynne, Kathryn E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2012
Last updated Nov 16th, 2020 - about 6 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 1619239050 NPPES
Massachusetts Other S400226313 MEDICARE
Massachusetts MEDICAID 110103143A MEDICARE

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