Provider Demographics
NPI:1386155877
Name:PAQUETTE, KATRYN (MD)
Entity type:Individual
Prefix:
First Name:KATRYN
Middle Name:
Last Name:PAQUETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 MOUNT AUBURN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4627
Mailing Address - Country:US
Mailing Address - Phone:617-864-7071
Mailing Address - Fax:617-661-4682
Practice Address - Street 1:575 MOUNT AUBURN ST STE 202
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4627
Practice Address - Country:US
Practice Address - Phone:617-864-7071
Practice Address - Fax:617-661-4682
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA273337208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics