Provider Demographics
NPI:1659443059
Name:PREVIGLIAN, TONYA L (CRNA)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:L
Last Name:PREVIGLIAN
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:4511 HARLEM RD RM 3
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3822
Mailing Address - Country:US
Mailing Address - Phone:716-886-0444
Mailing Address - Fax:716-885-7070
Practice Address - Street 1:4185 SENECA ST
Practice Address - Street 2:SUITE 11
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3565
Practice Address - Country:US
Practice Address - Phone:716-674-8189
Practice Address - Fax:716-712-0469
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY412948-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC6796Medicare ID - Type Unspecified
NY537854Medicare UPIN