Provider Demographics
NPI:1366765521
Name:O'BRIEN, JAMES SEAN (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SEAN
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33 COLLAMER DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4348
Mailing Address - Country:US
Mailing Address - Phone:518-899-5844
Mailing Address - Fax:518-885-7460
Practice Address - Street 1:4 FRONT ST
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-1778
Practice Address - Country:US
Practice Address - Phone:518-885-7330
Practice Address - Fax:518-885-7460
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist