Provider Demographics
NPI:1528244373
Name:JAMES E ONEILL PHYSICIAN PC
Entity type:Organization
Organization Name:JAMES E ONEILL PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTIOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:212-251-0921
Mailing Address - Street 1:PO BOX 30535
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-0535
Mailing Address - Country:US
Mailing Address - Phone:760-414-1438
Mailing Address - Fax:760-414-1575
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:914-737-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148373174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY22D371Medicare PIN