Provider Demographics
NPI:1477640340
Name:O'LEARY, PATRICK F (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:F
Last Name:O'LEARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MADISON AVE
Mailing Address - Street 2:4TH FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-249-8100
Mailing Address - Fax:212-249-8144
Practice Address - Street 1:1015 MADISON AVE
Practice Address - Street 2:4TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-249-8100
Practice Address - Fax:212-249-8144
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113664207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113664OtherWORKERS COMP
B12657Medicare UPIN
NY307841Medicare PIN