Provider Demographics
NPI:1720860752
Name:O'NEIL, JILLIAN (MS)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 83RD ST APT 9C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2875
Mailing Address - Country:US
Mailing Address - Phone:203-521-7885
Mailing Address - Fax:
Practice Address - Street 1:201 E 83RD ST APT 9C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2875
Practice Address - Country:US
Practice Address - Phone:203-521-7885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133N00000XDietary & Nutritional Service ProvidersNutritionist