Provider Demographics
NPI:1013291319
Name:OCONNOR, BARBARA BONNIE ANN (ATR-BC,LCAT)
Entity Type:Individual
Prefix:
First Name:BARBARA BONNIE
Middle Name:ANN
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:ATR-BC,LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2916
Mailing Address - Country:US
Mailing Address - Phone:516-764-3027
Mailing Address - Fax:
Practice Address - Street 1:205 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2916
Practice Address - Country:US
Practice Address - Phone:516-764-3027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7048211221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist