Healthcare Provider Details

I. General information

NPI: 1962277558
Provider Name (Legal Business Name): KONLIAN,O'NEILL & ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2023
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34434 KING STREET ROW STE 1
LEWES DE
19958-4987
US

IV. Provider business mailing address

659 S SALISBURY BLVD STE 1B
SALISBURY MD
21801-5458
US

V. Phone/Fax

Practice location:
  • Phone: 302-200-9920
  • Fax: 302-703-6652
Mailing address:
  • Phone: 410-831-3226
  • Fax: 410-572-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JANICE M BALDWIN
Title or Position: REGIONAL MANAGER
Credential:
Phone: 410-831-3226