Keith Daniel O'Leary, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0035661 Issued in NY

Practice address

236 Christian Ave
Stony Brook, NY 11790-1234

Phone

(631) 751-3149

Fax

(631) 689-6844

NPI assigned

Mar 23, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1437390309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CHRISTIAN AVE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-751-3149",
            "fax_number": "631-689-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 CHRISTIAN AVE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901234",
            "telephone_number": "631-751-3149",
            "fax_number": "631-689-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "KEITH",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0035661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan O'Connell, RBT
• Krista M O'Donnell, FNP-C
• Rita Susan O'Dwyer, DDS
• Alison Ashley O'Keefe, MD
• Allyson Nicole O'Kula
• Mary Kerin O'Neill, L.C.S.W.
• Meghan O'Neill, PA-C
• Neil Obeso, DPT
• Craig Peter Obrien, MFT
• William Ocampo

• Psychologist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.