National Provider Identifier

Jacqueline Shanahan, D.O

Jacqueline Shanahan, D.O is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Orchard Park, NY and a listed phone number of (716) 662-5357.

NPI 1104072701Orchard Park, NYFamily Medicine Physician

Profile Overview

NPI
1104072701
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
August 14, 2008
Last Updated
December 13, 2021

Practice Location

  • 3670 S Benzing RD
  • Orchard Park, NY 14127

Phone: (716) 662-5357

Mailing Address

  • 425 Essjay RD Ste 170
  • Williamsville, NY 14221-5782

Specialties

  • Family Medicine Physician (207Q00000X)
  • Student in an Organized Health Care Education/Training Program (390200000X)

Endpoints

  • production@direct.buffalomedicalgroup.com

    Direct Messaging Address | Orchard Park, NY 14127

Full Record
NPI
1104072701
Entity Type
Individual
Last Name
Shanahan
First Name
Jacqueline
Name Prefix
Dr.
Credential
D.O
Mailing Street Address
425 Essjay RD Ste 170
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221-5782
Mailing Country
US
Mailing Phone
(716) 630-1219
Practice Street Address
3670 S Benzing RD
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127
Practice Country
US
Practice Phone
(716) 662-5357
Enumeration Date
August 14, 2008
Last Updated
December 13, 2021
Sex
Female
Sole Proprietor
No
Certification Date
December 13, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X), Student in an Organized Health Care Education/Training Program (390200000X)