Provider Demographics
NPI:1790909737
Name:O'HARA, NANCY HOFREUTER (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:HOFREUTER
Last Name:O'HARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HOLLYHOCK LANE
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897
Mailing Address - Country:US
Mailing Address - Phone:203-834-2813
Mailing Address - Fax:203-834-2831
Practice Address - Street 1:3 HOLLYHOCK RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4443
Practice Address - Country:US
Practice Address - Phone:203-834-2813
Practice Address - Fax:203-834-2831
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032831208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics