Provider Demographics
NPI:1194564476
Name:DAVID O'CONNOR, NURSE PRACTITIONER IN PSYCHIATRY
Entity type:Organization
Organization Name:DAVID O'CONNOR, NURSE PRACTITIONER IN PSYCHIATRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:315-507-2299
Mailing Address - Street 1:90 KIRKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323-1436
Mailing Address - Country:US
Mailing Address - Phone:315-982-8673
Mailing Address - Fax:
Practice Address - Street 1:4685 MIDDLE SETTLEMENT RD STE 6
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-4938
Practice Address - Country:US
Practice Address - Phone:315-507-2299
Practice Address - Fax:338-438-1681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty