O'Leary, Kathleen P

O'Leary, Kathleen P is an individual health care provider with primary practice located at 10 Lincoln Sq , Worcester MA 01608-1135. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is her primary health care specialty. O'Leary, Kathleen P can be contacted via phone (508) 373-5830.

Contact Information

Primary practice address
10 Lincoln Sq Worcester MA 01608-1135
Fax: (508) 519-5512
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046010471 Illinois
Eye and Vision Services Providers / Pediatrics 152WP0200X 046010471 Illinois
Eye and Vision Services Providers / Optometrist 152W00000X 5008 Massachusetts
Eye and Vision Services Providers / Optometrist 152W00000X ODTG00633 Rhode Island

Profile Details

NPI number 1790072650
LBN Legal business name O'Leary, Kathleen P
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2011
Last updated Oct 6th, 2016 - about 10 years ago

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 1790072650 NPPES
Illinois Other 502720046 MEDICARE PTAN
Illinois MEDICAID 046010471 MEDICARE PTAN

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