Individual
KELLY O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 N BROADWAY, JERICHO, NY 11753-2011
(516) 681-2020
(516) 681-2410
Mailing address
328 N BROADWAY, JERICHO, NY 11753-2011
(516) 681-2020
(516) 681-2410
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007945
NY
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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