Provider Demographics
NPI:1972852036
Name:O'CONNOR, KERRI LYNN (AUD)
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:LYNN
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5113
Mailing Address - Country:US
Mailing Address - Phone:914-333-5800
Mailing Address - Fax:914-333-2540
Practice Address - Street 1:990 STEWART AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4822
Practice Address - Country:US
Practice Address - Phone:516-222-1881
Practice Address - Fax:516-222-1885
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002432-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist