Provider Demographics
NPI:1952322588
Name:OBRIEN, THOMAS KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KEVIN
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:160 STATE HIGHWAY 37 WEST
Mailing Address - Street 2:SUITE A DEER CHASE PROFESSIONAL PARK
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8056
Mailing Address - Country:US
Mailing Address - Phone:732-286-0440
Mailing Address - Fax:732-286-2885
Practice Address - Street 1:160 STATE HIGHWAY 37 WEST
Practice Address - Street 2:SUITE A DEER CHASE PROFESSIONAL PARK
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8056
Practice Address - Country:US
Practice Address - Phone:732-286-0440
Practice Address - Fax:732-286-2885
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04864200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1475509Medicaid
NJ1475509Medicaid
D19623Medicare UPIN