Healthcare Provider Details

I. General information

NPI: 1457020596
Provider Name (Legal Business Name): PEAK PEDIATRIC CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2021
Last Update Date: 11/24/2021
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 E WASHINGTON ST UNIT 2
NORTH ATTLEBORO MA
02760-2488
US

IV. Provider business mailing address

652 E WASHINGTON ST UNIT 2
NORTH ATTLEBORO MA
02760-2488
US

V. Phone/Fax

Practice location:
  • Phone: 508-576-5010
  • Fax: 508-213-3685
Mailing address:
  • Phone: 508-576-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRYN HANSEN
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 508-576-5010