Provider Demographics
NPI:1740367945
Name:ANKER, JEFFREY LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LAWRENCE
Last Name:ANKER
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 1:4955 N. BAILEY AVE.
Mailing Address - Street 2:STE 130
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-835-1246
Mailing Address - Fax:716-835-0396
Practice Address - Street 1:4955 N. BAILEY AVE.
Practice Address - Street 2:STE 130
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-835-1246
Practice Address - Fax:716-835-0396
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO180762084P0800X
NY1080912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01180769Medicaid
COD23384Medicare UPIN
COC3851Medicare PIN