Healthcare Provider Details

I. General information

NPI: 1659443059
Provider Name (Legal Business Name): TONYA L PREVIGLIAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MAIN ST
OLEAN NY
14760-1513
US

IV. Provider business mailing address

4511 HARLEM RD RM 3
AMHERST NY
14226-3822
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-2600
  • Fax:
Mailing address:
  • Phone: 716-886-0444
  • Fax: 716-885-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number412948-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: