Provider Demographics
NPI:1235169848
Name:SPERRY, HOWARD E (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:E
Last Name:SPERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:462 GRIDER STREET SUITE C-113
Mailing Address - Street 2:(VIP PRIMARY CARE)
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-4899
Mailing Address - Fax:716-961-7076
Practice Address - Street 1:462 GRIDER STREET
Practice Address - Street 2:SUITE C-113
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-4899
Practice Address - Fax:716-961-7076
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000507017002OtherHEALTHNOW BC OF WNY
NY00010171001OtherUNIVERA
NYJ400016253OtherMEDICARE PTAN
NY0409317OtherINDEPENDENT HEALTH
NY0409317OtherINDEPENDENT HEALTH
NY00010171001OtherUNIVERA