Provider Demographics
NPI:1538267919
Name:O NEILL, TERRENCE PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:PATRICK
Last Name:O NEILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 POTOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1214
Mailing Address - Country:US
Mailing Address - Phone:716-884-4450
Mailing Address - Fax:716-881-1217
Practice Address - Street 1:616 POTOMAC AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1214
Practice Address - Country:US
Practice Address - Phone:716-884-4450
Practice Address - Fax:716-881-1217
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009399-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB9710Medicare ID - Type Unspecified