MEDICARE: TINA O'NEILL

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1619373917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA O'NEILL

Provider Business Mailing Address
First Line	:	458 CIRCLE DR
Second Line	:
City	:	NEWTON FALLS
State	:	OH
Zip	:	44444-1222
Country	:	US
Telephone Number	:	330-610-0873
Fax Number	:

Provider Business Practice Location Address
First Line	:	458 CIRCLE DR
Second Line	:
City	:	NEWTON FALLS
State	:	OH
Zip	:	44444-1222
Country	:	US
Telephone Number	:	330-610-0873
Fax Number	:

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

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	11/13/2014

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Directions to “ TINA O'NEILL ” Practice Location

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