Individual
MARY R O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.P.A.-C.
Contact information
Practice address
80 CROSSWAYS PARK DR, WOODBURY, NY 11797-2047
(631) 796-9488
Mailing address
791 N WELLWOOD AVE, LINDENHURST, NY 11757
(631) 957-2200
(631) 957-4619
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004014
NY
Other
Enumeration date
07/07/2009
Last updated
09/27/2018
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