Provider Demographics
NPI:1720218621
Name:O'CONNOR, MEGHAN ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:O'CONNOR
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 1:10 SEAPORT DR
Mailing Address - Street 2:UNIT 2416
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1582
Mailing Address - Country:US
Mailing Address - Phone:201-925-6308
Mailing Address - Fax:
Practice Address - Street 1:10 SEAPORT DR
Practice Address - Street 2:UNIT 2416
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1582
Practice Address - Country:US
Practice Address - Phone:201-925-6308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program