Provider Demographics
NPI:1710475421
Name:O'BRIEN, COREY JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:JAMES
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 HAMMOND RD
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1258
Mailing Address - Country:US
Mailing Address - Phone:201-390-0587
Mailing Address - Fax:
Practice Address - Street 1:66 HAMMOND RD
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341-1258
Practice Address - Country:US
Practice Address - Phone:201-390-0587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2336921835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy