Healthcare Provider Details

I. General information

NPI: 1730062910
Provider Name (Legal Business Name): MARINA LUCILLE O'HARE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MCKINLEY AVE
WHITE PLAINS NY
10606-1646
US

IV. Provider business mailing address

55 MCKINLEY AVE APT D1-4
WHITE PLAINS NY
10606-1661
US

V. Phone/Fax

Practice location:
  • Phone: 973-222-9521
  • Fax:
Mailing address:
  • Phone: 973-222-9521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number947400
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: