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General NPI Number Information
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NPI Number | 1013580166
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Entity Type | Individual
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Provider Name | MARYA KATE CASARTELLO PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 2 WAKE ROBIN RD
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City | LINCOLN
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State | RI
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Zip | 02865-4295
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Country | US
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Telephone | 401-333-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 214 CONVERSE ST
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City | LONGMEADOW
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State | MA
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Zip | 01106-1704
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Country | US
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Telephone | 413-519-9657
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA8276
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01727
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License Number State | RI
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