Provider Demographics
NPI:1720088081
Name:SCRIVANI, STEPHEN PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PHILIP
Last Name:SCRIVANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LIMESTONE DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8602
Mailing Address - Country:US
Mailing Address - Phone:716-632-1400
Mailing Address - Fax:716-632-5316
Practice Address - Street 1:18 LIMESTONE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8602
Practice Address - Country:US
Practice Address - Phone:716-632-1400
Practice Address - Fax:716-632-5316
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00500476002OtherHEALTHNOW
NY00840455Medicaid
NY0102404OtherIHA
NY00010161302OtherUNIVERA
NY00500476002OtherHEALTHNOW