Provider Demographics
NPI:1295468049
Name:O'CONNOR, MICHAEL PATRICK (PA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:85 CANTERBURY CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-6211
Mailing Address - Country:US
Mailing Address - Phone:317-918-1962
Mailing Address - Fax:
Practice Address - Street 1:2999 PRINCETON PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3261
Practice Address - Country:US
Practice Address - Phone:609-403-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant