Provider Demographics
NPI:1285657312
Name:O'NEILL, NADINE (DC)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2897
Mailing Address - Country:US
Mailing Address - Phone:631-262-6900
Mailing Address - Fax:631-754-0678
Practice Address - Street 1:120 WOODBINE AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2897
Practice Address - Country:US
Practice Address - Phone:631-262-6900
Practice Address - Fax:631-754-0678
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0032371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX1899XFNA1Medicare PIN
NYT52426Medicare UPIN