Basic Information
Provider Information | |||||||||
NPI: | 1215995808 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SAVOY | ||||||||
FirstName: | NANCY | ||||||||
MiddleName: | A | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | NP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 908 NIAGARA FALLS BLVD | ||||||||
Address2: | SUITE 208 | ||||||||
City: | NORTH TONAWANDA | ||||||||
State: | NY | ||||||||
PostalCode: | 141202019 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7166923302 | ||||||||
FaxNumber: | 7162130935 | ||||||||
Practice Location | |||||||||
Address1: | 520 DELAWARE AVE | ||||||||
Address2: |   | ||||||||
City: | BUFFALO | ||||||||
State: | NY | ||||||||
PostalCode: | 142021304 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7165923600 | ||||||||
FaxNumber: | 7165923613 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/03/2006 | ||||||||
LastUpdateDate: | 02/04/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | F4202591 | NY | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
ID | Type | State | Issuer | Description | 000570238005 | 01 | NY | HEALTH NOW BCBS LEGACY# | OTHER | 00355266 | 05 | NY |   | MEDICAID | 9513163 | 01 | NY | IHA LEGACY# | OTHER | 177093CK | 01 | NY | PREFERRED CARE LEGACY# | OTHER |