Provider Demographics
NPI:1912256082
Name:O'BANION, JOY (TSHH)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:O'BANION
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:HERRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TSHH
Mailing Address - Street 1:777 MARYVALE DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2712
Mailing Address - Country:US
Mailing Address - Phone:716-631-9515
Mailing Address - Fax:
Practice Address - Street 1:777 MARYVALE DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2712
Practice Address - Country:US
Practice Address - Phone:716-631-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist