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NPI Code Detail

MEDICARE: ROBERT MICHAEL O'CONNOR LCSW

MEDICARE: ROBERT MICHAEL O'CONNOR LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker103835-1NY

General Provider Information

NPI Number : 1972099232
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT MICHAEL O'CONNOR LCSW
Provider Business Mailing Address
First Line : 9 TEAMSTER LN
Second Line :
City : LEVITTOWN
State : NY
Zip : 11756-5225
Country : US
Telephone Number : 516-361-9695
Fax Number :
Provider Business Practice Location Address
First Line : 535 S OYSTER BAY RD
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-3310
Country : US
Telephone Number : 516-888-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2018
Last Update Date : 07/04/2024

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