Provider Demographics
NPI:1508235615
Name:O'NEIL, MICHAELA ANN
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ANN
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:ANN
Other - Last Name:MURZYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3425 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2779
Mailing Address - Country:US
Mailing Address - Phone:814-864-4100
Mailing Address - Fax:814-866-1811
Practice Address - Street 1:3425 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2779
Practice Address - Country:US
Practice Address - Phone:814-864-4100
Practice Address - Fax:814-866-1811
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
PAPT028569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist