Provider Demographics
NPI:1528339934
Name:BARGER, KALYN R (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KALYN
Middle Name:R
Last Name:BARGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KALYN
Other - Middle Name:R
Other - Last Name:DHROSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:60 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2205
Practice Address - Country:US
Practice Address - Phone:978-466-2685
Practice Address - Fax:978-466-2746
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012003975363A00000X, 363AS0400X
MAPA5184363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110118909AMedicaid