Provider Demographics
NPI:1346204377
Name:O NEILL, ELIZABETH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:O NEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 ALBERTA DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1855
Mailing Address - Country:US
Mailing Address - Phone:716-837-4089
Mailing Address - Fax:716-837-4851
Practice Address - Street 1:350 ALBERTA DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1855
Practice Address - Country:US
Practice Address - Phone:719-837-4089
Practice Address - Fax:716-837-4851
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY193863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14436BMedicare ID - Type Unspecified
NYF79055Medicare UPIN