Dunleavy, Marykate

Dunleavy, Marykate is an individual health care provider with primary practice located at 593 Eddy St , Providence RI 02903-4923. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Dunleavy, Marykate can be contacted via phone (401) 519-1604.

Contact Information

Primary practice address
593 Eddy St Providence RI 02903-4923
Phone: (401) 519-1604
Fax: (401) 272-0538
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001873 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA00489 Rhode Island

Profile Details

NPI number 1396800520
LBN Legal business name Dunleavy, Marykate
Credentials MSPAS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Feb 5th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396800520 NPPES
Rhode Island Other 05/29/2009 BCBS
Rhode Island MEDICAID MD74353 BCBS
Rhode Island Other 1396800520 BCBS
Rhode Island Other 939025129 BCBS
Rhode Island Other 05/14/2009 BCBS
Rhode Island Other 979006382 BCBS

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