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Individual

MR. MATTHEW J O'CONNOR SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
404 BIRCHWOOD RD, MEDFORD, NY 11763-1232
(631) 566-1147
Mailing address
404 BIRCHWOOD RD, MEDFORD, NY 11763-1232
(631) 566-1147

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
408736
NY

Other

Enumeration date
06/21/2012
Last updated
06/21/2012
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