Individual
JOHN O' LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4904 19TH AVE, ASTORIA, NY 11105-1002
(718) 777-3494
Mailing address
4904 19TH AVE, ASTORIA, NY 11105-1002
(718) 777-3494
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401157
NY
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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