Provider Demographics
NPI:1891362182
Name:PAUL, MADELYNN MARGARET (PA-C)
Entity type:Individual
Prefix:
First Name:MADELYNN
Middle Name:MARGARET
Last Name:PAUL
Suffix:
Gender:
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:51 CUSTER ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3184
Mailing Address - Country:US
Mailing Address - Phone:315-939-4706
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:CARDIOLOGY, SUITE 4TH FL CCP
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-2375
Practice Address - Fax:617-789-5177
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPA8361363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant