Healthcare Provider Details

I. General information

NPI: 1588296297
Provider Name (Legal Business Name): CARISSA DAWN CUFAUDE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W JUBAL EARLY DR STE 240
WINCHESTER VA
22601-6319
US

IV. Provider business mailing address

6 GREENSIDE WAY S STE 1
PLYMOUTH MA
02360-6706
US

V. Phone/Fax

Practice location:
  • Phone: 540-450-2706
  • Fax: 540-450-2741
Mailing address:
  • Phone: 508-210-5890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: