Healthcare Provider Details

I. General information

NPI: 1861914186
Provider Name (Legal Business Name): CATHERINE FITZGERALD MCCABE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE MURPHY FITZGERALD

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON ST
BOSTON MA
02111-1552
US

IV. Provider business mailing address

11 STRATFORD RD
WINCHESTER MA
01890-3530
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5000
  • Fax:
Mailing address:
  • Phone: 301-806-8757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2280783
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2280783
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: