Provider Demographics
NPI:1275669897
Name:DODICK, CATHERINE M (RN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:DODICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SYLVAN KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5316
Mailing Address - Country:US
Mailing Address - Phone:203-353-9960
Mailing Address - Fax:
Practice Address - Street 1:214 SYLVAN KNOLL RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5316
Practice Address - Country:US
Practice Address - Phone:203-353-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE43568163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health