Provider Demographics
NPI:1730536921
Name:O'CONNOR, JANET (MD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:O'CONNOR
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 1:2296 OPITZ BLVD
Mailing Address - Street 2:#255
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3300
Mailing Address - Country:US
Mailing Address - Phone:571-285-3370
Mailing Address - Fax:
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:#255
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3300
Practice Address - Country:US
Practice Address - Phone:571-285-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046843208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice