Provider Demographics
NPI:1295097053
Name:O'ROURKE, PAMELA DAWN
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:DAWN
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3346 GALWAY RD
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2024
Mailing Address - Country:US
Mailing Address - Phone:518-884-9158
Mailing Address - Fax:
Practice Address - Street 1:3346 GALWAY RD
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2024
Practice Address - Country:US
Practice Address - Phone:518-884-9158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist