1417945387 NPI number — KATHLEEN M MCCARTEN MD

Table of content: KATHLEEN M MCCARTEN MD (NPI 1417945387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417945387 NPI number — KATHLEEN M MCCARTEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCARTEN
Provider First Name:
KATHLEEN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417945387
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 CATAMORE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02914-1204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-432-2520
Provider Business Mailing Address Fax Number:
401-432-2457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 CATAMORE BLVD
Provider Second Line Business Practice Location Address:
RHODE ISLAND MEDICAL IMAGING
Provider Business Practice Location Address City Name:
EAST PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02914-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-432-2520
Provider Business Practice Location Address Fax Number:
401-432-2457
Provider Enumeration Date:
10/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  9105 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7005386 . This is a "RI MEDICAL ASSISTANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400040 . This is a "BLUECHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0162728 . This is a "MASSMEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 009105 . This is a "BLUESHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 734765 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000001988 . This is a "NHPRI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0162728 . This is a "HEALTHSTART" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1600203 . This is a "UNITED HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 241275 . This is a "RJHPILGRIM" identifier . This identifiers is of the category "OTHER".




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