Healthcare Provider Details

I. General information

NPI: 1609809151
Provider Name (Legal Business Name): KONLIAN,O'NEILL & ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 02/25/2024
Certification Date: 02/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 CYNWOOD DR STE 101
EASTON MD
21601-3875
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 410-770-9720
  • Fax: 410-770-9725
Mailing address:
  • Phone: 410-860-5910
  • Fax: 410-860-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

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