Healthcare Provider Details

I. General information

NPI: 1588501654
Provider Name (Legal Business Name): ABIGAIL MACKENZIE O'NEILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 DOWLIN FORGE RD
EXTON PA
19341-1548
US

IV. Provider business mailing address

67 DOWLIN FORGE RD
EXTON PA
19341-1548
US

V. Phone/Fax

Practice location:
  • Phone: 610-594-2001
  • Fax: 484-872-8046
Mailing address:
  • Phone: 610-594-2001
  • Fax: 484-872-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: