Provider Demographics
NPI:1275927766
Name:O'LEARY, ROBERT
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:O'LEARY
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 1:1367 WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1048
Mailing Address - Country:US
Mailing Address - Phone:518-489-2666
Mailing Address - Fax:518-701-2929
Practice Address - Street 1:1367 WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1048
Practice Address - Country:US
Practice Address - Phone:518-489-2666
Practice Address - Fax:518-701-2929
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL145991207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery