Provider Demographics
NPI:1548203797
Name:O'NEILL, JOSEPH JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JAMES
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 KENYON AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4241
Mailing Address - Country:US
Mailing Address - Phone:401-789-9210
Mailing Address - Fax:401-792-3699
Practice Address - Street 1:70 KENYON AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4239
Practice Address - Country:US
Practice Address - Phone:401-789-9210
Practice Address - Fax:401-792-3699
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD03726207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology