Provider Demographics
NPI:1780340372
Name:O'NEILL, JOHN PATRICK (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:MB BCH BAO
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Mailing Address - Street 1:104 FRANKLIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6740
Mailing Address - Country:US
Mailing Address - Phone:857-370-2812
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PATHOLOGY BCH 3027
Practice Address - Street 2:300 LONGWOOD AVENUE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA287180207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology