Provider Demographics
NPI:1891880902
Name:MEANEY-ELMAN, NORA (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:MEANEY-ELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8171 SHERIDAN DR
Mailing Address - Street 2:STE 600
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6002
Mailing Address - Country:US
Mailing Address - Phone:716-839-7107
Mailing Address - Fax:716-839-5803
Practice Address - Street 1:8171 SHERIDAN DR
Practice Address - Street 2:STE 600
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6002
Practice Address - Country:US
Practice Address - Phone:716-839-7107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1676321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0103760OtherINDEPENDENT HEALTH
NY000510390001OtherBLUE CROSS WNY
NY0103760OtherINDEPENDENT HEALTH
NYE58825Medicare UPIN