MEDICARE: BRENDANNE ONEIL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	1491	CT
2	225200000X	Physical Therapy Assistant	8942	MA

General Provider Information

NPI Number	:	1265841381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDANNE ONEIL

Provider Business Mailing Address
First Line	:	202 ALMIRA RD
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01119-1404
Country	:	US
Telephone Number	:	413-386-3674
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 ALMIRA RD
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01119-1404
Country	:	US
Telephone Number	:	413-386-3674
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	08/04/2014

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Directions to “ BRENDANNE ONEIL ” Practice Location

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