Provider Demographics
NPI:1720628613
Name:SPORSKI, SARAH ANN (FNP-BC, RNFA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:SPORSKI
Suffix:
Gender:F
Credentials:FNP-BC, RNFA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:MAHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3098
Mailing Address - Country:US
Mailing Address - Phone:716-898-3381
Mailing Address - Fax:716-961-6969
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3098
Practice Address - Country:US
Practice Address - Phone:716-898-3381
Practice Address - Fax:716-961-6969
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345355363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner