Provider Demographics
NPI:1073535696
Name:VERNON, CATHERINE M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:M
Last Name:VERNON
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:119 SNOWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-8697
Mailing Address - Country:US
Mailing Address - Phone:315-672-8228
Mailing Address - Fax:315-425-2489
Practice Address - Street 1:800 IRVING AVE
Practice Address - Street 2:VAMC SYRACUSE
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2716
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:315-425-2489
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175891-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine