Provider Demographics
NPI:1891795225
Name:OBRIEN, LAURENE CATHERINE (NP, PSYCH,MH)
Entity Type:Individual
Prefix:MS
First Name:LAURENE
Middle Name:CATHERINE
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:NP, PSYCH,MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GEORGE DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1808
Mailing Address - Country:US
Mailing Address - Phone:518-371-3831
Mailing Address - Fax:
Practice Address - Street 1:8 GEORGE DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-1808
Practice Address - Country:US
Practice Address - Phone:518-371-3831
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY40 400344363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health