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NPI Code Detail

MEDICARE: ALEXANDER THOMAS O'BRIEN PMHNP

MEDICARE: ALEXANDER THOMAS O'BRIEN PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner234518MA

General Provider Information

NPI Number : 1598420770
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER THOMAS O'BRIEN PMHNP
Provider Business Mailing Address
First Line : 300 SOUTH ST
Second Line :
City : CHESTNUT HILL
State : MA
Zip : 02467-3694
Country : US
Telephone Number : 617-676-3320
Fax Number :
Provider Business Practice Location Address
First Line : 300 SOUTH ST
Second Line :
City : CHESTNUT HILL
State : MA
Zip : 02467-3694
Country : US
Telephone Number : 617-469-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2021
Last Update Date : 03/13/2023

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