Provider Demographics
NPI:1245085463
Name:NEWCOMB, KATHRYN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 PROVIDENCE HIGHWAY, ROUTE 1 SOUTH
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-278-5540
Mailing Address - Fax:
Practice Address - Street 1:1177 PROVIDENCE HIGHWAY, ROUTE 1 SOUTH
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5029
Practice Address - Country:US
Practice Address - Phone:781-278-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA101173363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant