Healthcare Provider Details

I. General information

NPI: 1417492380
Provider Name (Legal Business Name): ALLEGANY FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2016
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 CONSTITUTION AVE
OLEAN NY
14760-1840
US

IV. Provider business mailing address

2430 CONSTITUTION AVE
OLEAN NY
14760-1840
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-0700
  • Fax: 716-373-7270
Mailing address:
  • Phone: 716-373-0700
  • Fax: 716-373-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier05337779
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: CHANTEL M MCDOWELL
Title or Position: RN
Credential: RN
Phone: 716-244-1763