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General NPI Number Information
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NPI Number | 1215446240
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Entity Type | Individual
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Provider Name | CHRISTINE O'CONNELL OD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 116 WOLF RD
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City | ALBANY
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State | NY
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Zip | 12205-1164
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Country | US
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Telephone | 518-438-8600
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Fax | 518-438-8601
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Provider Business Mailing Address
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Address Line | 140 S WALDRON LN
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City | WYNANTSKILL
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State | NY
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Zip | 12198-8613
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Country | US
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Telephone |
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV008595
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License Number State | NY
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