Provider Demographics
NPI:1588799787
Name:RUFO, KATHERINE M (PA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:RUFO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-3501
Mailing Address - Country:US
Mailing Address - Phone:781-461-8508
Mailing Address - Fax:
Practice Address - Street 1:19 NORWOOD ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-2709
Practice Address - Country:US
Practice Address - Phone:617-394-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAP 808363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant