Healthcare Provider Details

I. General information

NPI: 1861574311
Provider Name (Legal Business Name): NORMA O'BRIEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 LAKEWOOD AVE HUDSON RIVER HEALTHCARE, INC.
MONTICELLO NY
12701-2021
US

IV. Provider business mailing address

1037 MAIN ST HUDSON RIVER HEALTHCARE, INC.
PEEKSKILL NY
10566-2913
US

V. Phone/Fax

Practice location:
  • Phone: 845-794-2010
  • Fax: 845-794-4569
Mailing address:
  • Phone: 914-734-8800
  • Fax: 914-734-8786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number446102-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number332895
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: