Provider Demographics
NPI:1568633287
Name:O'NEIL, CAROLYN JANE
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JANE
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 PLAISTOW RD
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2897
Mailing Address - Country:US
Mailing Address - Phone:603-382-8565
Mailing Address - Fax:603-974-0887
Practice Address - Street 1:168 PLAISTOW RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2897
Practice Address - Country:US
Practice Address - Phone:603-382-8565
Practice Address - Fax:603-974-0887
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3064M174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist