Healthcare Provider Details

I. General information

NPI: 1720050719
Provider Name (Legal Business Name): MEAGAN O'NEILL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 JAMES RD
IPSWICH MA
01938-1140
US

IV. Provider business mailing address

13 JAMES RD
IPSWICH MA
01938-1140
US

V. Phone/Fax

Practice location:
  • Phone: 203-217-0265
  • Fax:
Mailing address:
  • Phone: 203-217-0265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007533
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7448
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25266
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: