Provider Demographics
NPI:1629515234
Name:O'CONNOR, VERONICA PATRICIA (PMHNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:PATRICIA
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 E WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2143
Mailing Address - Country:US
Mailing Address - Phone:609-287-2245
Mailing Address - Fax:
Practice Address - Street 1:638 E WOOD AVE
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-2143
Practice Address - Country:US
Practice Address - Phone:609-287-2245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-21
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSP017096363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health