Provider Demographics
NPI:1669471041
Name:ONEIL, VIRGINIA C (PA-C)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:C
Last Name:ONEIL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:STE 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-798-8012
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:STE 360
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:787-762-0471
Practice Address - Fax:787-762-0671
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2009-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1109363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAP119401Medicare PIN
MAAD1194Medicare ID - Type Unspecified
599716Medicare UPIN