Individual
EVAN O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
605 MAIN ST, HACKENSACK, NJ 07601-5914
(201) 881-7321
Mailing address
230 GILBERT AVE, PEARL RIVER, NY 10965-3016
(845) 893-8076
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40QA01750000
NJ
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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