Provider Demographics
NPI:1790943298
Name:O'BRIEN, FRANK
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E 63RD ST
Mailing Address - Street 2:APT 20-L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:504 E 63RD ST
Practice Address - Street 2:APT 20-L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7919
Practice Address - Country:US
Practice Address - Phone:212-355-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 P53301390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program