Provider Demographics
NPI:1578851267
Name:O'NEIL, MATTHEW (DPT)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E MADISON AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1424
Mailing Address - Country:US
Mailing Address - Phone:856-905-8363
Mailing Address - Fax:
Practice Address - Street 1:101 BURRS RD
Practice Address - Street 2:BUILDING 1, SUITE D
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5517
Practice Address - Country:US
Practice Address - Phone:609-261-1060
Practice Address - Fax:609-261-0615
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01403100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist