Provider Demographics
NPI:1497865927
Name:ONEILL, TANYA M (CRNA)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:M
Last Name:ONEILL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10439
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08650-4039
Mailing Address - Country:US
Mailing Address - Phone:609-581-5303
Mailing Address - Fax:609-631-6839
Practice Address - Street 1:2119 HIGHWAY 33
Practice Address - Street 2:SUITE B
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-1740
Practice Address - Country:US
Practice Address - Phone:609-581-5303
Practice Address - Fax:609-631-6839
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00225500367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ035435M5FMedicare ID - Type Unspecified