Provider Demographics
NPI:1295719474
Name:O'NEIL, ANNETTE D (MD)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:D
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1412 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2908
Mailing Address - Country:US
Mailing Address - Phone:215-599-4851
Mailing Address - Fax:215-232-4093
Practice Address - Street 1:1401 DEKALB ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3405
Practice Address - Country:US
Practice Address - Phone:610-278-7787
Practice Address - Fax:610-278-7386
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2021-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD040618E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012244920003Medicaid
PA0012244920003Medicaid
PAE 52936Medicare UPIN