Individual
MR. TIMOTHY MICHAEL O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.N.S.
Contact information
Practice address
2928 W 36TH ST, BROOKLYN, NY 11224-1410
(718) 372-3300
(718) 972-1314
Mailing address
2928 W 36TH ST, BROOKLYN, NY 11224-1410
(718) 372-3300
(718) 972-1314
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
278191
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401805-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04067387
—
NY
Enumeration date
09/19/2007
Last updated
05/10/2016
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