Provider Demographics
NPI:1912488966
Name:IRWIN, CAILY CHANDLER (PA-C)
Entity Type:Individual
Prefix:
First Name:CAILY
Middle Name:CHANDLER
Last Name:IRWIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHA CAMBRIDGE HOSPITAL - SURGERY
Mailing Address - Street 2:1493 CAMBRIDGE STREET
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139
Mailing Address - Country:US
Mailing Address - Phone:617-665-2555
Mailing Address - Fax:617-665-3598
Practice Address - Street 1:235 CYPRESS ST UNIT 201
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6776
Practice Address - Country:US
Practice Address - Phone:617-383-6250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6687363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty