Provider Demographics
NPI:1801592951
Name:O'BRIEN, ADAM GORDON (APRN, RN, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:GORDON
Last Name:O'BRIEN
Suffix:
Gender:
Credentials:APRN, RN, PMHNP-BC
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Mailing Address - Street 1:581 SYLVAN RD
Mailing Address - Street 2:
Mailing Address - City:RIVER VALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6029
Mailing Address - Country:US
Mailing Address - Phone:201-707-4722
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7182
Practice Address - Fax:914-493-7152
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT10.180247163W00000X
NH09190023363LP0808X
CT011631363LP0808X
NJ26NJ01472800363LP0808X
NY404805363LP0808X
NJ26NR15624200163W00000X
NY668512163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse