Basic Information
Provider Information
NPI: 1275807455
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: O'BEIRNE
FirstName: SARAH
MiddleName: LOUISE
NamePrefix: DR.
NameSuffix:  
Credential: MB BCH BAO PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1320 YORK AVE APT 16A
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214857
CountryCode: US
TelephoneNumber: 6463271265
FaxNumber:  
Practice Location
Address1: 425 E 61ST ST FL 4
Address2:  
City: NEW YORK
State: NY
PostalCode: 10065
CountryCode: US
TelephoneNumber: 6469622333
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/06/2012
LastUpdateDate: 06/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X285870NYY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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