Provider Demographics
NPI:1164441499
Name:O'NEILL, ESTHER COLENE (ANP)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:COLENE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WINCHELL DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13209-1446
Mailing Address - Country:US
Mailing Address - Phone:315-487-2238
Mailing Address - Fax:
Practice Address - Street 1:BROAD RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-5100
Practice Address - Country:US
Practice Address - Phone:315-492-5635
Practice Address - Fax:315-492-5633
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300767363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health