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NPI Code Detail

MEDICARE: MCKENNA WILLIAMS

MEDICARE:   MCKENNA  WILLIAMS
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
1363A00000XPhysician AssistantPA102601MA

General Provider Information

NPI Number : 1821979857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA WILLIAMS
Provider Business Mailing Address
First Line : 360 US HIGHWAY 1 BYP UNIT 102
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-7105
Country : US
Telephone Number : 603-410-6700
Fax Number : 603-309-9601
Provider Business Practice Location Address
First Line : 20 COMMERCIAL RD
Second Line :
City : LEOMINSTER
State : MA
Zip : 01453-3339
Country : US
Telephone Number : 978-798-6896
Fax Number : 978-798-6897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2025
Last Update Date : 06/04/2026

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Directions to “ MCKENNA WILLIAMS ” Practice Location

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