MEDICARE: PATRICIA A ODONNELL DO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1649983529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA A ODONNELL DO PLLC

Provider Business Mailing Address
First Line	:	8171 SHERIDAN DR STE 600
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6002
Country	:	US
Telephone Number	:	716-839-7107
Fax Number	:	716-839-5803

Provider Business Practice Location Address
First Line	:	8171 SHERIDAN DR STE 600
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6002
Country	:	US
Telephone Number	:	716-839-7107
Fax Number	:	716-839-5803

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	PATRICIA A O'DONNELL
Credential	:	DO
Telephone Number	:	716-839-7107

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	01/05/2023

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