Individual
MARY JEAN O
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 ROBERT WOOD JOHNSON PL, DEPARTMENT OF EMERGENCY MEDICINE, NEW BRUNSWICK, NJ 08901-1928
(732) 937-8700
Mailing address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(475) 210-5604
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA09247300
NJ
207P00000X
Emergency Medicine Physician
267682
NY
207P00000X
Emergency Medicine Physician
51520
CT
Other
Enumeration date
06/05/2009
Last updated
10/28/2020
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