National Provider Identifier
Michael James Fennell II, PA-C
Michael James Fennell II, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Orchard Park, NY and a listed phone number of (716) 675-2500.
Profile Overview
- NPI
- 1023765708
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- March 03, 2022
- Last Updated
- March 03, 2022
Practice Location
- 3055 Southwestern Blvd Ste 100
- Orchard Park, NY 14127-1231
Phone: (716) 675-2500
Mailing Address
- 9673 Garden Walk
- Clarence Center, NY 14032-9411
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1023765708
- Entity Type
- Individual
- Last Name
- Fennell
- First Name
- Michael
- Middle Name
- James
- Name Prefix
- Mr.
- Name Suffix
- II
- Credential
- PA-C
- Mailing Street Address
- 9673 Garden Walk
- Mailing City
- Clarence Center
- Mailing State
- NY
- Mailing ZIP Code
- 14032-9411
- Mailing Country
- US
- Practice Street Address
- 3055 Southwestern Blvd Ste 100
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-1231
- Practice Country
- US
- Practice Phone
- (716) 675-2500
- Enumeration Date
- March 03, 2022
- Last Updated
- March 03, 2022
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 03, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)