Individual
THOMAS MATTHEW O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
8000 UTOPIA PKWY, JAMAICA, NY 11439-9000
(631) 903-5951
Mailing address
8000 UTOPIA PKWY, JAMAICA, NY 11439-9000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
67 003159
NY
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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