Healthcare Provider Details

I. General information

NPI: 1417179094
Provider Name (Legal Business Name): EXIGENCE HOSPITALIST MEDICAL SERVICES OF OLEAN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MAIN STREET
OLEAN NY
14760
US

IV. Provider business mailing address

PO BOX 3398
BUFFALO NY
14240-3398
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-4500
  • Fax: 716-692-4342
Mailing address:
  • Phone: 716-692-3302
  • Fax: 716-692-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number159276
License Number StateNY

VIII. Authorized Official

Name: STEPHEN G HOLTZCLAW
Title or Position: OWNER
Credential: MD
Phone: 856-686-4317