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General NPI Number Information
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NPI Number | 1033459425
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Entity Type | Organization
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Legal Business Name | KATHLEEN M OCONNELL DPM PC
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 495 E WATERFRONT DRIVE SUITE 230
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City | HOMESTEAD
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State | PA
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Zip | 15120-1151
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Country | US
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Telephone | 412-461-1108
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Fax | 412-461-5490
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Provider Business Mailing Address
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Address Line | 495 WATERFRONT DR E SUITE 230
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City | HOMESTEAD
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State | PA
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Zip | 15120-1140
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Country | US
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Telephone | 412-461-1108
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Fax | 412-461-5490
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Authorized Official
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Title or Position | OWNER
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Name | KATHLEEN M OCONNELL
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Credential | DPM, PC
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Telephone | 412-461-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC005681
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License Number State | PA
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