Provider Demographics
NPI:1548735970
Name:LYNN O'CONNOR PHYSICIAN P.C.
Entity Type:Organization
Organization Name:LYNN O'CONNOR PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OCONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-350-6277
Mailing Address - Street 1:51 RUSHMORE ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4427
Mailing Address - Country:US
Mailing Address - Phone:631-327-4400
Mailing Address - Fax:
Practice Address - Street 1:380 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2869
Practice Address - Country:US
Practice Address - Phone:631-350-6277
Practice Address - Fax:631-350-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty