Provider Demographics
NPI:1912694811
Name:MARHEFKA, CAROLINE COSGRAVE (OD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:COSGRAVE
Last Name:MARHEFKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 STURGES ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-1023
Mailing Address - Country:US
Mailing Address - Phone:949-382-8530
Mailing Address - Fax:
Practice Address - Street 1:424 BEACON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-1129
Practice Address - Country:US
Practice Address - Phone:617-266-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program