1265439509 NPI number — JANET KAYE ONEAL D.O.

Table of content: JANET KAYE ONEAL D.O. (NPI 1265439509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265439509 NPI number — JANET KAYE ONEAL D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ONEAL
Provider First Name:
JANET
Provider Middle Name:
KAYE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARRIS
Provider Other First Name:
JANET
Provider Other Middle Name:
KAYE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1265439509
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9709 STONEYBROOK DRIVE
Provider Second Line Business Mailing Address:
OFFICE AND RESIDENCE
Provider Business Mailing Address City Name:
KENSINGTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20895-3146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-589-7441
Provider Business Mailing Address Fax Number:
301-495-8991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9709 STONEYBROOK DRIVE
Provider Second Line Business Practice Location Address:
OFFICE AND RESIDENCE
Provider Business Practice Location Address City Name:
KENSINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20895-3146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-589-7441
Provider Business Practice Location Address Fax Number:
301-495-8991
Provider Enumeration Date:
07/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  H0043745 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 374502300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 31380001 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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