Provider Demographics
NPI:1255611133
Name:PEVZNER, KATHRYN A
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:PEVZNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1041
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02331-1041
Mailing Address - Country:US
Mailing Address - Phone:781-424-4336
Mailing Address - Fax:
Practice Address - Street 1:36 PLUMFIELD LN
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-3823
Practice Address - Country:US
Practice Address - Phone:781-424-4336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management