Provider Demographics
NPI:1437574738
Name:OCONNOR, MARY HELEN (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HELEN
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2495 REDDING RD
Mailing Address - Street 2:FAIRFIELD
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-1703
Mailing Address - Country:US
Mailing Address - Phone:203-218-8431
Mailing Address - Fax:
Practice Address - Street 1:2495 REDDING RD
Practice Address - Street 2:FAIRFIELD
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-1703
Practice Address - Country:US
Practice Address - Phone:203-218-8431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-23
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2826831163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse