Healthcare Provider Details

I. General information

NPI: 1497035208
Provider Name (Legal Business Name): KAYSE L. BARRY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

IV. Provider business mailing address

1000 FARMINGTON AVE STE 109A
WEST HARTFORD CT
06107-2185
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-5919
  • Fax: 855-818-2207
Mailing address:
  • Phone: 860-910-8669
  • Fax: 855-818-2207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6784
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00704
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6784
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA4688
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: