Healthcare Provider Details

I. General information

NPI: 1306837703
Provider Name (Legal Business Name): CATHERINE E DENNEHY PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 02/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST SUITE 468 - GREEN BUILDING
NEWTON MA
02462-1650
US

IV. Provider business mailing address

2000 WASHINGTON ST SUITE 468 - GREEN BUILDING
NEWTON MA
02462-1650
US

V. Phone/Fax

Practice location:
  • Phone: 617-965-6700
  • Fax: 617-965-5239
Mailing address:
  • Phone: 617-965-6700
  • Fax: 617-965-5239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number138485
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: