Provider Demographics
NPI:1295277531
Name:O'CONNOR, ERIC (APRN, DNP)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JEWETT CITY
Mailing Address - State:CT
Mailing Address - Zip Code:06351-2226
Mailing Address - Country:US
Mailing Address - Phone:860-376-7040
Mailing Address - Fax:
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:JEWETT CITY
Practice Address - State:CT
Practice Address - Zip Code:06351-2226
Practice Address - Country:US
Practice Address - Phone:860-376-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6832363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health