Healthcare Provider Details

I. General information

NPI: 1598102840
Provider Name (Legal Business Name): CAITLIN FAY ANDERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MAIN ST STE 201
MEDFORD MA
02155-4530
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DHMC, DEPARTMENT OF PEDIATRICS
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 978-505-5753
  • Fax:
Mailing address:
  • Phone: 978-505-5753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number283284
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: