Provider Demographics
NPI:1457020596
Name:PEAK PEDIATRIC CARE, PLLC
Entity Type:Organization
Organization Name:PEAK PEDIATRIC CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-576-5010
Mailing Address - Street 1:652 E WASHINGTON ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-2488
Mailing Address - Country:US
Mailing Address - Phone:508-576-5010
Mailing Address - Fax:
Practice Address - Street 1:652 E WASHINGTON ST UNIT 2
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-2488
Practice Address - Country:US
Practice Address - Phone:508-576-5010
Practice Address - Fax:508-213-3685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-11
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty