Provider Demographics
NPI:1932460011
Name:O'CONNOR, ANDREA M (MSSPEDU/ASL)
Entity Type:Individual
Prefix:PROF
First Name:ANDREA
Middle Name:M
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MSSPEDU/ASL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 BEACH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-9642
Mailing Address - Country:US
Mailing Address - Phone:716-870-0629
Mailing Address - Fax:
Practice Address - Street 1:4921 BEACH RIDGE RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9642
Practice Address - Country:US
Practice Address - Phone:716-870-0629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist