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General NPI Number Information
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NPI Number | 1023232071
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Entity Type | Organization
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Legal Business Name | ALLYN M. NORMAN
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1825 MAPLE RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2723
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Country | US
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Telephone | 716-204-4532
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Fax | 716-204-4557
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Provider Business Mailing Address
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Address Line | 1825 MAPLE RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2723
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Country | US
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Telephone | 716-204-4532
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Fax | 716-204-4557
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. ALLYN M NORMAN
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Credential | DO
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Telephone | 716-204-4532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 153492
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License Number State | NY
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