Healthcare Provider Details

I. General information

NPI: 1871114264
Provider Name (Legal Business Name): DANIELLE NICHOLE O'HARA GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE NICHOLE O'HARA MD

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MONTAUK HWY
WEST ISLIP NY
11795-4910
US

IV. Provider business mailing address

1111 MONTAUK HWY
WEST ISLIP NY
11795-4910
US

V. Phone/Fax

Practice location:
  • Phone: 631-376-6185
  • Fax: 631-376-6189
Mailing address:
  • Phone: 631-376-6185
  • Fax: 631-376-6189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number346309
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: