Provider Demographics
NPI:1710086426
Name:PEREZ-SENN, NANCY (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:PEREZ-SENN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4511 HARLEM RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3822
Mailing Address - Country:US
Mailing Address - Phone:716-839-6720
Mailing Address - Fax:716-839-6740
Practice Address - Street 1:219 BRYANT ST
Practice Address - Street 2:GENERAL PEDIATRIC DIVISION
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-878-7288
Practice Address - Fax:716-888-3966
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211130208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01885221Medicaid
NY040426001561OtherFIDELIS
NY0017212460001OtherPA MEDICAID
NY00010367501OtherUNIVERA
NY080407000113OtherFIDELIS
NY1210119OtherIHA
NY000525258001OtherBC/BS