Provider Demographics
NPI:1407160997
Name:DONNELLY, MEGAN C (PA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:DONNELLY
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Gender:F
Credentials:PA
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Mailing Address - Street 1:550 ORCHARD PARK RD.
Mailing Address - Street 2:SUITE A105
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2654
Mailing Address - Country:US
Mailing Address - Phone:716-677-6000
Mailing Address - Fax:716-677-6006
Practice Address - Street 1:550 ORCHARD PARK RD.
Practice Address - Street 2:SUITE B103
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2654
Practice Address - Country:US
Practice Address - Phone:716-677-5005
Practice Address - Fax:716-712-0160
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2013-11-14
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Provider Licenses
StateLicense IDTaxonomies
NY014027363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant