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Marykate Dunleavy, MSPAS,PA-C
Medical Physician Assistant in Providence, Rhode Island
NPI 1396800520

Marykate Dunleavy is a Medical Physician Assistant based in Providence, RI and is specialized in Medical. Marykate Dunleavy practices in Providence, RI and has the professional credentials of MSPAS,PA-C. The NPI Number for Marykate Dunleavy is 1396800520 and holds a License No. 001873 (Rhode Island).

The current practice location address for Marykate Dunleavy is 593 Eddy St, Providence, RI and can be reached out via phone at 401-519-1604 and via fax at 401-272-0538.

Location: 593 Eddy St, Providence, RI, 02940-9484
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Provider Profile Details
NPI Number
1396800520
Provider Name
Marykate Dunleavy
Credential
MSPAS,PA-C
Provider Entity Type
Individual
Gender
Female
Address
593 Eddy St, Providence, RI, 02940-9484
Phone Number
401-519-1604
Fax Number
401-272-0538
Provider Enumeration Date
12/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
05/29/2009 01 RI BCBS
MD74353 05 RI
1396800520 01 RI NPI
939025129 01 RI RI MEDICARE GROUP NUMBER
05/14/2009 01 RI NHPRI
979006382 01 RI RI MEDICARE
institution
Provider Business Practice Location Address Details
Address
593 Eddy St
City
State
Zip
02903-4923
Phone Number
401-519-1604
Fax Number
401-272-0538
person
Provider Business Mailing Address Details
Address
593 Eddy St
City
State
Zip
02903-4923
Phone Number
401-519-1604
Fax Number
401-272-0538
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
001873 (Connecticut)
Definition
Definition to come...
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