O'Shaughnessy, Alice Marie

O'Shaughnessy, Alice Marie is an sole proprietor health care provider with primary practice located at 4747-20 Nesconset Hwy , Port Jefferson Station NY 11776-2894. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. O'Shaughnessy, Alice Marie can be contacted via phone (631) 474-5500.

Contact Information

Primary practice address
4747-20 Nesconset Hwy Port Jefferson Station NY 11776-2894
Fax: (631) 474-2568
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 107072 New York

Profile Details

NPI number 1093886509
LBN Legal business name O'Shaughnessy, Alice Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2006
Last updated Sep 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093886509 NPPES
New York MEDICAID 00765540

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