Provider Demographics
NPI:1427341312
Name:O'SHEA, MARY ANN THERESA (FNP)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:THERESA
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1000
Mailing Address - Country:US
Mailing Address - Phone:914-472-3333
Mailing Address - Fax:
Practice Address - Street 1:531 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1000
Practice Address - Country:US
Practice Address - Phone:914-472-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY336118OtherLICENSE