Provider Demographics
NPI:1518132505
Name:O'BRIEN, DANIEL PATRICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:O'BRIEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 OSBORNE ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6043
Mailing Address - Country:US
Mailing Address - Phone:203-739-7038
Mailing Address - Fax:203-739-1961
Practice Address - Street 1:111 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6043
Practice Address - Country:US
Practice Address - Phone:203-739-7038
Practice Address - Fax:203-739-1961
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53019207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program