Provider Demographics
NPI:1053536094
Name:DR. PATRICIA C. O'BRIEN, PC
Entity type:Organization
Organization Name:DR. PATRICIA C. O'BRIEN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-782-7500
Mailing Address - Street 1:321 YALE AVE
Mailing Address - Street 2:A
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1247
Mailing Address - Country:US
Mailing Address - Phone:856-782-7500
Mailing Address - Fax:856-782-0075
Practice Address - Street 1:321 YALE AVE
Practice Address - Street 2:A
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1247
Practice Address - Country:US
Practice Address - Phone:856-782-7500
Practice Address - Fax:856-782-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00419800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0207600000OtherPROVIDER ID
NJ103774OtherPROVIDER ID
NJ2632234OtherPROVIDER ID
NJ2364020OtherPROVIDER ID
NJ0151772000OtherPROVIDER ID
NJP11081097OtherPROVIDER ID
NJ103774OtherPROVIDER ID
NJ103774OtherPROVIDER ID
NJP11081097OtherPROVIDER ID