MEDICARE: KATELYN DUTKIEWICZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA3740	MA

General Provider Information

NPI Number	:	1134368400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN DUTKIEWICZ

Provider Business Mailing Address
First Line	:	17 RESEARCH DRIVE
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2178
Country	:	US
Telephone Number	:	413-549-8400
Fax Number	:	413-549-8409

Provider Business Practice Location Address
First Line	:	17 RESEARCH DRIVE
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2178
Country	:	US
Telephone Number	:	413-549-8400
Fax Number	:	413-549-8409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	07/25/2018

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Directions to “ KATELYN DUTKIEWICZ ” Practice Location

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