Healthcare Provider Details

I. General information

NPI: 1528987773
Provider Name (Legal Business Name): JOSEPH PATRICK O'CONNELL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5216 BONDSOR LN
RICHMOND VA
23225-2909
US

IV. Provider business mailing address

5216 BONDSOR LN
RICHMOND VA
23225-2909
US

V. Phone/Fax

Practice location:
  • Phone: 301-335-2977
  • Fax:
Mailing address:
  • Phone: 301-335-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306606861
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: