Provider Demographics
NPI:1669733556
Name:O'CONNOR, JANINE AGNES
Entity type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:AGNES
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 GARFIELD PL
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1026
Mailing Address - Country:US
Mailing Address - Phone:516-593-8655
Mailing Address - Fax:516-593-8655
Practice Address - Street 1:106 GARFIELD PL
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1026
Practice Address - Country:US
Practice Address - Phone:516-593-8655
Practice Address - Fax:516-593-8655
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist