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General NPI Number Information
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NPI Number | 1154725497
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Entity Type | Individual
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Provider Name | MEGHAN O'NEILL PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 101 NICOLLS RD HSC- L4, RM 050
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City | STONY BROOK
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State | NY
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Zip | 11794-8350
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Country | US
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Telephone | 631-444-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 50 PINE ST
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City | BLUE POINT
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State | NY
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Zip | 11715-1118
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Country | US
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Telephone | 631-697-6956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 018121-1
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License Number State | NY
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