Provider Demographics
NPI:1528060118
Name:O CONNOR, JOSEPH S (PT SCS)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:S
Last Name:O CONNOR
Suffix:
Gender:M
Credentials:PT SCS
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Mailing Address - Street 1:1 MARKET ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1011
Mailing Address - Country:US
Mailing Address - Phone:781-592-0540
Mailing Address - Fax:781-592-0989
Practice Address - Street 1:39 CROSS ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1670
Practice Address - Country:US
Practice Address - Phone:978-538-7370
Practice Address - Fax:978-538-7372
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA67612251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001270OtherNEIGHBORHOOD HLTH
MA540790OtherCIGNA HEALTH SOURCE
MA766575OtherBCBS
MA2049990OtherAETNA
MA626117OtherHCHP
MAY61243OtherBCBS GROUP
MA64 00088OtherUNITED HEALTH
MA0365106Medicaid
2153514OtherFIRST HEALTH
MA612043OtherTUFTS
MA626117OtherHCHP