Provider Demographics
NPI:1992071930
Name:O'HARE, MARY G (NP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:G
Last Name:O'HARE
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Gender:F
Credentials:NP
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Mailing Address - Street 1:255 W LANCASTER AVE
Mailing Address - Street 2:PAOLI HOSPITAL
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1763
Mailing Address - Country:US
Mailing Address - Phone:484-565-1649
Mailing Address - Fax:484-565-8062
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:PAOLI HOSPITAL
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1763
Practice Address - Country:US
Practice Address - Phone:484-565-1600
Practice Address - Fax:610-647-2006
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2015-10-22
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Provider Licenses
StateLicense IDTaxonomies
PASP011668363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA248854HK1Medicare PIN