Provider Demographics
NPI:1467728626
Name:DORAN, CATHY ANN O'MALLEY
Entity Type:Individual
Prefix:MRS
First Name:CATHY ANN
Middle Name:O'MALLEY
Last Name:DORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 FURROWS RD
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2706
Mailing Address - Country:US
Mailing Address - Phone:631-676-3145
Mailing Address - Fax:
Practice Address - Street 1:286 FURROWS RD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-2706
Practice Address - Country:US
Practice Address - Phone:631-676-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277626-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse