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General NPI Number Information
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NPI Number | 1578851267
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Entity Type | Individual
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Provider Name | MATTHEW O'NEIL D.P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 101 BURRS RD BUILDING 1, SUITE D
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City | WESTAMPTON
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State | NJ
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Zip | 08060-5517
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Country | US
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Telephone | 609-261-1060
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Fax | 609-261-0615
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Provider Business Mailing Address
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Address Line | 211 E MADISON AVE FLOOR 2
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City | COLLINGSWOOD
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State | NJ
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Zip | 08108-1424
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Country | US
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Telephone | 856-905-8363
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01403100
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License Number State | NJ
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