Healthcare Provider Details

I. General information

NPI: 1952220782
Provider Name (Legal Business Name): KATIE ONEILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 PARK AVE
FAIRFIELD CT
06825-1090
US

IV. Provider business mailing address

60 WOODBURY ST APT 2
NEW ROCHELLE NY
10805-1588
US

V. Phone/Fax

Practice location:
  • Phone: 203-371-7999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF358430-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: