Provider Demographics
NPI:1467572149
Name:O'CONNOR, CATHERINE IMELDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:IMELDA
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CEDARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-7632
Mailing Address - Country:US
Mailing Address - Phone:781-373-1728
Mailing Address - Fax:
Practice Address - Street 1:37 CEDARWOOD AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-7632
Practice Address - Country:US
Practice Address - Phone:781-373-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6847174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist