Provider Demographics
NPI:1740521194
Name:CASS, SHARYN LEE (ANP)
Entity type:Individual
Prefix:MRS
First Name:SHARYN
Middle Name:LEE
Last Name:CASS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SHARYN
Other - Middle Name:LEE
Other - Last Name:BRUNNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2343 LAPHAM RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2705
Mailing Address - Country:US
Mailing Address - Phone:716-329-3249
Mailing Address - Fax:833-450-0825
Practice Address - Street 1:4535 SOUTHWESTERN BLVD STE 705B
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1870
Practice Address - Country:US
Practice Address - Phone:716-329-3249
Practice Address - Fax:833-450-0825
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306343363LA2200X
NYF306343363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03573053Medicaid