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Individual

MS. CATHERINE P DODGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
6 18TH ST, MILLER PLACE, NY 11764-3427
(631) 849-3426
Mailing address
6 18TH ST, MILLER PLACE, NY 11764-3427
(631) 849-3426

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
376230-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7423123
NY
Enumeration date
06/13/2008
Last updated
06/13/2008
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