Individual
PATRICIA L KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
850 HARRISON AVE, YACC5, BOSTON, MA 02118-4001
(617) 414-5946
(617) 414-4541
Mailing address
366 SHREWSBURY ST, WORCESTER, MA 01604-4647
(508) 595-2700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
229930
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110073939A
—
MA
Enumeration date
07/07/2006
Last updated
12/03/2021
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