MEDICARE: KATHERINE E WALTON-VECCHIO PA-C

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	PA5933	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871596247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE E WALTON-VECCHIO PA-C

Provider Business Mailing Address
First Line	:	421 N MAIN ST
Second Line	:
City	:	LEEDS
State	:	MA
Zip	:	01053-9764
Country	:	US
Telephone Number	:	413-584-5040
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 N MAIN ST
Second Line	:
City	:	LEEDS
State	:	MA
Zip	:	01053-9700
Country	:	US
Telephone Number	:	413-586-8400
Fax Number	:

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	01/16/2025

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