Organization Name: | KATHLEEN M OCONNELL DPM PC |
NPI Number: | 1033459425 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN M OCONNELL (OWNER) |
Mailing Address: | 495 E Waterfront Drive Suite 230 Homestead |
State: | PA US |
Postal Code: | 151201151 |
Phone Number: | 4124611108 |
Fax Number: | 4124615490 |
NPI Enumeration Date: | 02/21/2013 |
NPI Last Update Date: | 08/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | SC005681 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |