Provider Demographics
NPI:1003324773
Name:O'FLAHERTY, KATHLEEN (MED)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:O'FLAHERTY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 HARBOR LN APT 3C
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-1341
Mailing Address - Country:US
Mailing Address - Phone:201-988-4104
Mailing Address - Fax:
Practice Address - Street 1:37 HARBOR LN APT 3C
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-1341
Practice Address - Country:US
Practice Address - Phone:201-988-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist