Individual
THOMAS JASON O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-9494
Mailing address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-9494
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
015697
NY
Other
Enumeration date
07/08/2012
Last updated
07/08/2012
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