Provider Demographics
NPI:1275581431
Name:OGRA, SANJAY R (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:R
Last Name:OGRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8235
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:85 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1149
Practice Address - Country:US
Practice Address - Phone:716-630-1000
Practice Address - Fax:716-859-3555
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197304-1207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161000580OtherNORTH AMERICAN PREFERRED
NY161000580OtherEMPIRE
NY01843287Medicaid
NY000524477003OtherHEALTH NOW
NY0408987OtherIHA
NY161000580OtherAETNA
NY197304-9WOtherWORKERS COMPENSATION
NY00010200102OtherUNIVERA
NY110192880OtherRR MEDICARE
NY161000580OtherNOVA