Doctor Name: | KATHRYN ORA MASCHKA |
NPI Number: | 1326376898 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 002277 |
Business Practice Address: | 201 Chestnut Hill Rd Stafford Springs, CT - 060764005 |
Business Phone Number: | 8602306065 |
Business Fax Number: | |
Mailing Address: | Po Box 789, LUDLOW |
State: | MA |
Postal Code: | 010560789 |
Phone Number: | 4135091000 |
Fax Number: | 4135091003 |
NPI Enumeration Date: | 11/21/2009 |
NPI Last Update Date: | 03/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 002277 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |