Provider Demographics
NPI:1619048303
Name:DOOLEY, CATHERINE A (FNP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:A
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:SLOCUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:169 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4246
Mailing Address - Country:US
Mailing Address - Phone:607-352-1735
Mailing Address - Fax:607-352-1736
Practice Address - Street 1:169 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4246
Practice Address - Country:US
Practice Address - Phone:607-352-1735
Practice Address - Fax:607-352-1736
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331583363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S28716Medicare UPIN
NY11690PMedicare ID - Type Unspecified