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General NPI Number Information
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NPI Number | 1912996133
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Entity Type | Individual
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Provider Name | KATHERINE A O'DONNELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 55 SPINDRIFT DR STE 220
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7800
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Country | US
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Telephone | 716-626-6300
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Fax | 716-631-6312
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Provider Business Mailing Address
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Address Line | 55 SPINDRIFT DR. SUITE 220
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-626-6300
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Fax | 716-626-6312
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 198782
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License Number State | NY
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