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General NPI Number Information
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NPI Number | 1801802590
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Entity Type | Individual
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Provider Name | SHARON O'BRIEN
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 380 WASHINGTON AVE
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City | ROOSEVELT
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State | NY
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Zip | 11575-1845
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Country | US
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Telephone | 516-378-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2 PARK DR
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City | OLD BETHPAGE
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State | NY
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Zip | 11804-1510
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Country | US
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Telephone | 516-845-5477
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 00001766
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 018376
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License Number State | NY
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