Provider Demographics
NPI:1780991257
Name:TYE, KATE F (PA-C)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:F
Last Name:TYE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KATE
Other - Middle Name:F
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:56 COLPITTS ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493
Mailing Address - Country:US
Mailing Address - Phone:781-891-0906
Mailing Address - Fax:781-891-0912
Practice Address - Street 1:56 COLPITTS ROAD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493
Practice Address - Country:US
Practice Address - Phone:781-891-0906
Practice Address - Fax:781-891-0912
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine