Healthcare Provider Details

I. General information

NPI: 1932967361
Provider Name (Legal Business Name): KONLIAN, O'NEILL & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9954 N MAIN ST UNIT 3
BERLIN MD
21811-1299
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 443-513-3910
  • Fax: 443-513-3979
Mailing address:
  • Phone: 410-831-3226
  • Fax: 410-572-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

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