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General NPI Number Information
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NPI Number | 1124374400
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Entity Type | Organization
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Legal Business Name | DR. BILL OBRIEN
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 49 ROLLING LN
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City | LEVITTOWN
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State | PA
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Zip | 19055-1112
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Country | US
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Telephone | 215-378-0351
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Fax |
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Provider Business Mailing Address
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Address Line | 49 ROLLING LN
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City | LEVITTOWN
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State | PA
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Zip | 19055-1112
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Country | US
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Telephone | 215-378-0351
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. WILLIAM O'BRIEN III
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Credential | D.O.
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Telephone | 215-378-0351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | OS008318L
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License Number State | PA
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