Healthcare Provider Details

I. General information

NPI: 1851516116
Provider Name (Legal Business Name): CATHERINE JEAN FLANNERY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1357 MONROE AVE
ROCHESTER NY
14618-1005
US

IV. Provider business mailing address

31 STONE ISLAND LN
PENFIELD NY
14526-1017
US

V. Phone/Fax

Practice location:
  • Phone: 585-442-9601
  • Fax: 585-442-9606
Mailing address:
  • Phone: 585-249-0967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number164007
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: