Healthcare Provider Details

I. General information

NPI: 1063623205
Provider Name (Legal Business Name): SARA BETH LINDGREN O'REILLY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2007
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MADISON AVE SUITE 308
MORRISTOWN NJ
07960-6097
US

IV. Provider business mailing address

111 MADISON AVE SUITE 308
MORRISTOWN NJ
07960-6097
US

V. Phone/Fax

Practice location:
  • Phone: 973-285-0400
  • Fax:
Mailing address:
  • Phone: 973-285-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MB08374900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: