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General NPI Number Information
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NPI Number | 1356762595
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Entity Type | Individual
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Provider Name | SUZANNE O'CONNOR APRN
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Gender | Female
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 226 MILL HILL AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06610-2826
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Country | US
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Telephone | 203-384-3079
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Fax |
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Provider Business Mailing Address
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Address Line | 112 SUMMER LN
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3555
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Country | US
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Telephone | 203-605-8800
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5527
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License Number State | CT
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