Provider Demographics
NPI:1467889071
Name:SWORTS, JINYAN YU (NP)
Entity Type:Individual
Prefix:
First Name:JINYAN
Middle Name:YU
Last Name:SWORTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-1650
Mailing Address - Country:US
Mailing Address - Phone:716-652-1560
Mailing Address - Fax:716-652-0018
Practice Address - Street 1:292 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-1650
Practice Address - Country:US
Practice Address - Phone:716-652-1560
Practice Address - Fax:716-652-1800
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306470363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000536200001OtherBLUECROSS BLUESHIELD
NY1998533OtherINDEPENDENT HEALTH
NY1467889071OtherUNIVERA
NY03748538Medicaid
NYJ400099741Medicare Oscar/Certification