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General NPI Number Information
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NPI Number | 1992434294
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Entity Type | Organization
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Legal Business Name | O'CONNOR MEDICAL PLLC
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 9 ORCHARD ST
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City | PORT JERVIS
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State | NY
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Zip | 12771
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Country | US
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Telephone | 609-661-2946
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 312
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City | PORT JERVIS
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State | NY
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Zip | 12771-0312
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Country | US
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Telephone | 845-672-3017
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | BRANDON O'CONNOR
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Credential | MD
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Telephone | 609-661-2946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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