Provider Demographics
NPI:1083820898
Name:FARRISSEY, CATHERINE (DMD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:FARRISSEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:SAMAHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 3189
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13220-3189
Mailing Address - Country:US
Mailing Address - Phone:315-454-6000
Mailing Address - Fax:315-454-8650
Practice Address - Street 1:14 LOUDON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5344
Practice Address - Country:US
Practice Address - Phone:603-227-9899
Practice Address - Fax:603-227-9997
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist