Provider Demographics
NPI:1588695506
Name:ONEIL-HOLDING, KATHLEEN E (PT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:E
Last Name:ONEIL-HOLDING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 7TH AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-4901
Mailing Address - Country:US
Mailing Address - Phone:212-921-9036
Mailing Address - Fax:212-921-9038
Practice Address - Street 1:525 7TH AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4901
Practice Address - Country:US
Practice Address - Phone:212-921-9036
Practice Address - Fax:212-921-9038
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037560225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY037560OtherTHE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT
CAPT27376OtherCA LICENCE