Doctor Name: | KATHLEEN L O'MARA |
NPI Number: | 1689750697 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 334094 |
Business Practice Address: | 43 Main St. Livingston Manor, NY - 127580800 |
Business Phone Number: | 8454398731 |
Business Fax Number: | 8454398370 |
Mailing Address: | 314 Tonjes Rd, CALLICOON |
State: | NY |
Postal Code: | 127235742 |
Phone Number: | 8454823514 |
Fax Number: | 8454823507 |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 334094 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |