Provider Demographics
NPI:1861447518
Name:CHIAVEGATO, ANNE C (PA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:CHIAVEGATO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:C
Other - Last Name:SMART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 TER HEUN DR
Mailing Address - Street 2:FALMOUTH HOSPITAL - EMERGENCY DEPARTMENT
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2503
Mailing Address - Country:US
Mailing Address - Phone:508-457-3929
Mailing Address - Fax:508-457-3839
Practice Address - Street 1:100 TER HEUN DRIVE
Practice Address - Street 2:FALMOUTH HOSPITAL - EMERGENCY DEPARTMENT
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-457-3929
Practice Address - Fax:508-457-3839
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1219363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P26324Medicare UPIN
AP1426Medicare ID - Type Unspecified