Provider Demographics
NPI:1063783249
Name:O'BRIEN, JOHN SEBASTIAN II (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SEBASTIAN
Last Name:O'BRIEN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 HAMILTON ST
Mailing Address - Street 2:SUITE 1515
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-4201
Mailing Address - Country:US
Mailing Address - Phone:215-563-4141
Mailing Address - Fax:215-563-6191
Practice Address - Street 1:2001 HAMILTON ST
Practice Address - Street 2:SUITE 1515
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-4201
Practice Address - Country:US
Practice Address - Phone:215-563-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035503E2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry