Provider Demographics
NPI:1457315707
Name:HALLIDAY, FIONA C (MD)
Entity Type:Individual
Prefix:DR
First Name:FIONA
Middle Name:C
Last Name:HALLIDAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5879 SNYDER DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-9497
Mailing Address - Country:US
Mailing Address - Phone:716-433-8751
Mailing Address - Fax:716-433-8792
Practice Address - Street 1:5879 SNYDER DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9497
Practice Address - Country:US
Practice Address - Phone:716-433-8751
Practice Address - Fax:716-433-8792
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212450207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0110353OtherINDEPENDENT HEALTH
NY00020012402OtherUNIVERA
NY000525378005OtherBCBS OF WNY
NY01898402Medicaid
NY040819000065OtherFIDELIS
NY040819000065OtherFIDELIS
NYRA2422Medicare ID - Type Unspecified