Basic Information
Provider Information | |||||||||
NPI: | 1366934572 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ONEIL | ||||||||
FirstName: | CINDY | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 10 CORDAGE PARK CIR | ||||||||
Address2: |   | ||||||||
City: | PLYMOUTH | ||||||||
State: | MA | ||||||||
PostalCode: | 023607318 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6175332300 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 10 CORDAGE PARK | ||||||||
Address2: |   | ||||||||
City: | PLYMOUTH | ||||||||
State: | MA | ||||||||
PostalCode: | 02360 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7744543493 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/04/2018 | ||||||||
LastUpdateDate: | 08/03/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2264309 | MA | N |   | Nursing Service Providers | Registered Nurse |   | 363LF0000X | RN2264309 | MA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.