Provider Demographics
NPI:1619546421
Name:O'CONNOR-TERRY, CARLY
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:O'CONNOR-TERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 LOCUST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15209-2040
Mailing Address - Country:US
Mailing Address - Phone:412-779-7823
Mailing Address - Fax:
Practice Address - Street 1:MAGEE-WOMENS HOSPITAL, OUTPATIENT CLINIC, ZERO LEVEL
Practice Address - Street 2:300 HALKET STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-641-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program