Provider Demographics
NPI:1659533404
Name:O'NEILL, JENNA LYN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:LYN
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JENNA
Other - Middle Name:LYN
Other - Last Name:ARNDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-630-1219
Practice Address - Street 1:3900 NORTH BUFFALO ROAD
Practice Address - Street 2:BUFFALO MEDICAL GROUP
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127
Practice Address - Country:US
Practice Address - Phone:716-656-4829
Practice Address - Fax:716-250-5934
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01487207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology