Provider Demographics
NPI:1871791707
Name:O'CONNOR, NATASHA (PH,D)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:SOMWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2 GLENRICH DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1611
Mailing Address - Country:US
Mailing Address - Phone:917-743-2071
Mailing Address - Fax:
Practice Address - Street 1:2 GLENRICH DR
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1611
Practice Address - Country:US
Practice Address - Phone:917-743-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001206103K00000X
NY023028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst