Provider Demographics
NPI:1184969743
Name:O'SHAUGHNESSY, CATHERINE R
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:R
Last Name:O'SHAUGHNESSY
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 1:8 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2045
Mailing Address - Country:US
Mailing Address - Phone:401-575-6771
Mailing Address - Fax:
Practice Address - Street 1:8 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2045
Practice Address - Country:US
Practice Address - Phone:401-575-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program