Individual
DR. KATHLEEN P O'LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10 LINCOLN SQ, WORCESTER, MA 01608-1135
(508) 373-5830
(508) 519-5512
Mailing address
515 HOPE ST, PROVIDENCE, RI 02906-1630
(603) 533-2774
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010471
IL
152W00000X
Optometrist
Primary
5008
MA
152W00000X
Optometrist
ODTG00633
RI
152WP0200X
Pediatric Optometrist
046010471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046010471
—
IL
01
—
502720046
MEDICARE PTAN
IL
Enumeration date
06/29/2011
Last updated
10/06/2016
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