Provider Demographics
NPI:1154668523
Name:O'NEILL, ANNETTE (RD)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HEATH RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-2109
Mailing Address - Country:US
Mailing Address - Phone:732-829-5146
Mailing Address - Fax:908-996-2282
Practice Address - Street 1:202 HEATH RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-2109
Practice Address - Country:US
Practice Address - Phone:732-829-5146
Practice Address - Fax:908-996-2282
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ916310133V00000X
NJ133NN1002X, 133VN1004X, 133VN1005X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic