Provider Demographics
NPI:1710327036
Name:O'DAY, ROSEMARY THERESA (LPN)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:THERESA
Last Name:O'DAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CANAL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-2504
Mailing Address - Country:US
Mailing Address - Phone:631-503-7306
Mailing Address - Fax:
Practice Address - Street 1:4 CANAL VIEW DR
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-2504
Practice Address - Country:US
Practice Address - Phone:631-503-7306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2219281164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse