Provider Demographics
NPI:1386480598
Name:O'CONNOR, BRIANNA LYNN (COTA)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 OLD SYLVAN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5403
Mailing Address - Country:US
Mailing Address - Phone:845-661-9578
Mailing Address - Fax:
Practice Address - Street 1:3 SUMMIT CT
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1334
Practice Address - Country:US
Practice Address - Phone:845-218-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011383224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant