Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN1856843 | MA |
NPI | 1013359116 |
---|---|
Provider Name | Dr. Kathleen Marie Mccafferty |
First Address | Needham, MA 02492-2578 |
Second Address | Needham, MA 02492-2578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2013 |
Last Update Date | 09/05/2015 |