Provider Demographics
NPI:1356448567
Name:MICHAEL O'NEIL OD
Entity Type:Organization
Organization Name:MICHAEL O'NEIL OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-448-5172
Mailing Address - Street 1:140 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1271
Mailing Address - Country:US
Mailing Address - Phone:978-448-5172
Mailing Address - Fax:978-448-6353
Practice Address - Street 1:140 MAIN ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1271
Practice Address - Country:US
Practice Address - Phone:978-448-5172
Practice Address - Fax:978-448-6353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty