Basic Information
| Provider Information | |||||||||
| NPI: | 1265445233 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ONEILL | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HYGEIA DR STE 2300 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026237113 | ||||||||
| FaxNumber: | 3026233023 | ||||||||
| Practice Location | |||||||||
| Address1: | 4755 OGLETOWN STANTON RD STE 5A43 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197185854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026230188 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 09/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | C2-0003347 | DE | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | C20003347 | DE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1689862492 | 05 | DE | MEDICAID |