Individual
KATHLEEN A PETRUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 BROOKLINE PL, BROOKLINE, MA 02445-7296
(617) 784-5949
Mailing address
12 ASHLEY RD, SOUTHBOROUGH, MA 01772-1816
(617) 784-5949
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
205138
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110127328A
—
MA
Enumeration date
05/28/2006
Last updated
12/03/2020
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