Provider Demographics
NPI:1922216415
Name:O'CONNOR, MARGARET THERESA (APRN BC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:THERESA
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BOWDOIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2832
Mailing Address - Country:US
Mailing Address - Phone:617-786-8642
Mailing Address - Fax:
Practice Address - Street 1:750 WASHINGTON STREET
Practice Address - Street 2:NEMC GMA BOX 398
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-7889
Practice Address - Fax:617-636-6403
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN 155860 NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP 1478 MAMedicare ID - Type Unspecified