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General NPI Number Information
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NPI Number | 1609948355
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Entity Type | Individual
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Provider Name | MARIA DA CONCEICAO O'SHEA PT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 2 EXECUTIVE BLVD STE 204A
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City | SUFFERN
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State | NY
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Zip | 10901
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Country | US
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Telephone | 845-357-5686
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Fax | 845-357-3897
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Provider Business Mailing Address
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Address Line | 215 PINEVIEW AVE
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City | BARDONIA
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State | NY
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Zip | 10954
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Country | US
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Telephone | 845-624-0864
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Fax | 845-357-3897
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00525700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 023818
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License Number State | NY
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