Provider Demographics
NPI:1760421598
Name:MULQUEEN, CATHERINE T (DO)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:T
Last Name:MULQUEEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3003
Mailing Address - Country:US
Mailing Address - Phone:508-422-2922
Mailing Address - Fax:508-634-3687
Practice Address - Street 1:14 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3003
Practice Address - Country:US
Practice Address - Phone:508-422-2922
Practice Address - Fax:508-634-3687
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2212432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7293684OtherAETNA
MA110037730AMedicaid
11363079OtherCAQH ID#
MAAA568344OtherHARVARD PILGRIM HEALTH CARE
MAJ27556OtherMA BC/BS
MAAA568344OtherHARVARD PILGRIM HEALTH CARE
I08357Medicare UPIN