Provider Demographics
NPI:1780045617
Name:O'BRIEN, KYRA SAHAR (MD)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:SAHAR
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KYRA
Other - Middle Name:SAHAR
Other - Last Name:JEFFERSON-GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 CIVIC CENTER BLVD.
Mailing Address - Street 2:2ND FLOOR SOUTH PAVILION
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-3606
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BLVD.
Practice Address - Street 2:2ND FLOOR SOUTH PAVILION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-20
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4703532084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology