Individual
KATHERINE A O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 SPINDRIFT DR STE 220, WILLIAMSVILLE, NY 14221-7800
(716) 626-6300
(716) 631-6312
Mailing address
55 SPINDRIFT DR., SUITE 220, WILLIAMSVILLE, NY 14221
(716) 626-6300
(716) 626-6312
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
198782
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020516904
UNIVERA
NY
01
—
000525717005
BC/BS
NY
05
—
01956376
—
NY
01
—
040426002685
FIDELIS
NY
01
—
148119FL
PREFERRED CARE
NY
01
—
1710860
IHA
NY
01
—
460020
WELLCARE
NY
Enumeration date
10/20/2005
Last updated
04/23/2020
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