Provider Demographics
NPI:1194434951
Name:CANAVAN, PATRICK JOSEPH (PA-C)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:CANAVAN
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:82 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1271
Mailing Address - Country:US
Mailing Address - Phone:781-475-2456
Mailing Address - Fax:
Practice Address - Street 1:82 JUNIPER LN
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1271
Practice Address - Country:US
Practice Address - Phone:781-475-2456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant