Provider Demographics
NPI:1003131418
Name:O'NEILL, JANE MEAD (RPH)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:MEAD
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 WALDEN FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-9734
Mailing Address - Country:US
Mailing Address - Phone:518-475-7574
Mailing Address - Fax:518-475-9725
Practice Address - Street 1:87 WALDEN FIELDS DR
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-9734
Practice Address - Country:US
Practice Address - Phone:518-475-7574
Practice Address - Fax:518-475-9725
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist