Provider Demographics
NPI:1891183786
Name:MAGER-OCONNOR, ELIZABETH (GNP, BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MAGER-OCONNOR
Suffix:
Gender:F
Credentials:GNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1707
Mailing Address - Country:US
Mailing Address - Phone:845-558-2295
Mailing Address - Fax:
Practice Address - Street 1:15 ESSEX RD
Practice Address - Street 2:SUITE 305
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1451
Practice Address - Country:US
Practice Address - Phone:201-291-6000
Practice Address - Fax:201-291-6230
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00193600363LG0600X
NY340160-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology