Provider Demographics
NPI:1033159124
Name:OBRIEN, KATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 EISENHOWER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1430
Mailing Address - Country:US
Mailing Address - Phone:201-843-2800
Mailing Address - Fax:973-939-0273
Practice Address - Street 1:80 EISENHOWER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1430
Practice Address - Country:US
Practice Address - Phone:201-843-2800
Practice Address - Fax:973-939-0273
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08957200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI47240Medicare UPIN