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General NPI Number Information
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NPI Number | 1104099233
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Entity Type | Individual
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Provider Name | DENIECE O'LEARY PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 257 STATE ST
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City | BATAVIA
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State | NY
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Zip | 14020-1044
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Country | US
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Telephone | 585-343-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 150 VETERANS MEMORIAL HWY UNIT 141
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City | COMMACK
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State | NY
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Zip | 11725-6408
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Country | US
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Telephone | 289-400-4499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA17591
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License Number State | CA
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