Individual
MARIE O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306181-1
NY
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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