MEDICARE: MR. O'NEIL P MOREAU LPN

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	164W00000X	Licensed Practical Nurse	355809	NY

General Provider Information

NPI Number	:	1972456333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. O'NEIL P MOREAU LPN

Provider Business Mailing Address
First Line	:	PO BOX 355
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-0355
Country	:	US
Telephone Number	:	888-360-5551
Fax Number	:	845-504-2689

Provider Business Practice Location Address
First Line	:	PO BOX 355
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-0355
Country	:	US
Telephone Number	:	888-360-5551
Fax Number	:	845-504-2689

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

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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