Provider Demographics
NPI:1124291208
Name:O'BRIEN, DAVID NEAL (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:NEAL
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HOLLAND AVENUE
Mailing Address - Street 2:VA OUTPATIENT PHARMACY
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-626-5741
Mailing Address - Fax:518-626-5743
Practice Address - Street 1:113 HOLLAND AVE
Practice Address - Street 2:VA OUTPATIENT PHARMACY
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3410
Practice Address - Country:US
Practice Address - Phone:518-626-5741
Practice Address - Fax:518-626-5743
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist