Provider Demographics
NPI:1962715813
Name:O'NEILL, MICHAEL J (LAC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1391
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-1391
Mailing Address - Country:US
Mailing Address - Phone:201-788-0394
Mailing Address - Fax:201-664-1485
Practice Address - Street 1:285 PASCACK RD STE 4
Practice Address - Street 2:
Practice Address - City:TOWNSHIP OF WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07676-4841
Practice Address - Country:US
Practice Address - Phone:201-788-0394
Practice Address - Fax:201-664-1485
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00064600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist