Provider Demographics
NPI:1588086581
Name:O'BRIEN, ERIN
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-2302
Mailing Address - Country:US
Mailing Address - Phone:516-554-3685
Mailing Address - Fax:516-766-3634
Practice Address - Street 1:66 HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-2302
Practice Address - Country:US
Practice Address - Phone:516-554-3685
Practice Address - Fax:516-766-3634
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY503510163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics