Basic Information
| Provider Information | |||||||||
| NPI: | 1124312350 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'CONNOR | ||||||||
| FirstName: | THAO | ||||||||
| MiddleName: | THACH | ||||||||
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| Credential: | C-FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 STANIFORD ST | ||||||||
| Address2: | SUITE 340 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021142517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177268722 | ||||||||
| FaxNumber: | 6177266781 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 STANIFORD ST | ||||||||
| Address2: | SUITE 340 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021142517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177268722 | ||||||||
| FaxNumber: | 6177266781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2011 | ||||||||
| LastUpdateDate: | 05/28/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN252917 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.