Healthcare Provider Details

I. General information

NPI: 1679516496
Provider Name (Legal Business Name): MARNIE PRICE OBRIEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 17TH ST STE 101
ALLENTOWN PA
18104
US

IV. Provider business mailing address

825 E GATE BLVD STE 111
GARDEN CITY NY
11530-2136
US

V. Phone/Fax

Practice location:
  • Phone: 610-433-0450
  • Fax: 610-433-4655
Mailing address:
  • Phone: 516-804-5200
  • Fax: 516-240-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOS008987L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: