Provider Demographics
NPI:1205800810
Name:O'BRIEN, CATHERINE LLOYD (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LLOYD
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 FALLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-3149
Mailing Address - Country:US
Mailing Address - Phone:941-496-4010
Mailing Address - Fax:
Practice Address - Street 1:53 MARION RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-1406
Practice Address - Country:US
Practice Address - Phone:508-295-5572
Practice Address - Fax:508-291-2777
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34833207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2046229Medicaid
MAM08500OtherBLUECROSS BLUESHIELD
MA708925OtherTUFTS HEALTH INSURANCE
MA2237497OtherUNITED HEALTHCARE
MA2237497OtherUNITED HEALTHCARE
A22563Medicare PIN