Provider Demographics
NPI:1679818504
Name:SAXTON, SHEILA M
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:SAXTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14710-9680
Mailing Address - Country:US
Mailing Address - Phone:716-763-2086
Mailing Address - Fax:
Practice Address - Street 1:8685 ERIE RD
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:NY
Practice Address - Zip Code:14006-9620
Practice Address - Country:US
Practice Address - Phone:716-549-4454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008203174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist