Provider Demographics
NPI:1477511293
Name:SAWYER, THOMAS R (N P)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:R
Last Name:SAWYER
Suffix:
Gender:M
Credentials:N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5571 STRICKLER RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1336
Mailing Address - Country:US
Mailing Address - Phone:716-741-8230
Mailing Address - Fax:
Practice Address - Street 1:LRMC
Practice Address - Street 2:CMR 402, BOX 2425
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:DE
Practice Address - Phone:49637-185-7276
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR153283363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health