Provider Demographics
NPI:1023828282
Name:O'CONNOR, BRIAN O'NEIL
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:O'NEIL
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 E 49TH ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-7311
Mailing Address - Country:US
Mailing Address - Phone:917-755-1289
Mailing Address - Fax:
Practice Address - Street 1:348 E 49TH ST APT 5A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-7311
Practice Address - Country:US
Practice Address - Phone:917-755-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst