Provider Demographics
NPI:1265964456
Name:STANTON, KATE JEAN (MD)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:JEAN
Last Name:STANTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:JEAN
Other - Last Name:PELLEGRITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2473
Mailing Address - Country:US
Mailing Address - Phone:508-860-7800
Mailing Address - Fax:508-860-7862
Practice Address - Street 1:26 QUEEN STREET
Practice Address - Street 2:
Practice Address - City:WORCESSTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2473
Practice Address - Country:US
Practice Address - Phone:508-860-7800
Practice Address - Fax:508-860-7925
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA2874122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program