Healthcare Provider Details

I. General information

NPI: 1093705816
Provider Name (Legal Business Name): CARA L CHEVALIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA LEE SMITH

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 KINGSTOWN WAY
DUXBURY MA
02332-4605
US

IV. Provider business mailing address

169 MADISON AVE STE 2829
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 888-553-2823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number326807-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number224119
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: