Provider Demographics
NPI:1366415739
Name:OCONNELL, WILLIAM FRANCIS (OD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:OCONNELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 ANPELL DR
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6141
Mailing Address - Country:US
Mailing Address - Phone:914-723-8391
Mailing Address - Fax:914-723-8391
Practice Address - Street 1:32 ANPELL DR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6141
Practice Address - Country:US
Practice Address - Phone:914-723-8391
Practice Address - Fax:914-723-8391
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT003775152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00567639Medicaid
NY00567639Medicaid
NYA300001696Medicare PIN