Doctor Name: | KATHERINE SIOBHAN RIVEST |
NPI Number: | 1164766226 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA4575 |
Business Practice Address: | 2 Mechanic St Suite A Easthampton, MA - 010271562 |
Business Phone Number: | 4135299282 |
Business Fax Number: | 4135277526 |
Mailing Address: | 6 Parc Pl, Suite A SOUTHAMPTON |
State: | MA |
Postal Code: | 010739277 |
Phone Number: | 4135299282 |
Fax Number: | 4135277526 |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 01/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA4575 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |