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General NPI Number Information
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NPI Number | 1124380308
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Entity Type | Individual
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Provider Name | JAMES ALEXANDER O'SHEA TEACHER
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Gender | Male
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 150 BROADHOLLOW RD STE 360
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City | MELVILLE
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State | NY
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Zip | 11747-4988
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Country | US
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Telephone | 631-233-9490
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Fax | 631-233-9499
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Provider Business Mailing Address
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Address Line | 150 BROADHOLLOW RD STE 360
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City | MELVILLE
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State | NY
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Zip | 11747-4988
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Country | US
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Telephone | 631-233-9499
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Fax | 631-233-9499
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 891809
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F405095-1
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License Number State | NY
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