Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MA090510 | NJ |
NPI | 1063736510 |
---|---|
Provider Name | Dr. David J O'connor |
First Address | Hackensack, NJ 07601-3231 |
Second Address | Hackensack, NJ 07601-3231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 07/05/2015 |