| NPI |
1598305963 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
| Entity Type Code |
1 |
The country code in the location address of the provider being identified. |
| Provider Last Name Legal Name |
LAWSON |
The telephone number associated with the location address of the provider being identified. |
| Provider First Name |
SARAH |
The fax number associated with the location
address of the provider being identified. |
| Provider First Line Business Practice Location Address |
950A UNION RD |
The date the provider was assigned a unique identifier (assigned an NPI). |
| Provider Business Practice Location Address City Name |
WEST SENECA |
The city name in the location address of the provider being identified. |
| Provider Business Practice Location Address State Name |
NY |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address Postal Code |
142243465 |
The middle name of the authorized official. |
| Provider Business Practice Location Address Country Code If outside U S |
US |
The 10-position telephone number of the authorized official. |
| Provider Business Practice Location Address Telephone Number |
8182416780 |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
| Provider Enumeration Date |
1/13/2020 |
The date the provider was assigned a unique identifier (assigned an NPI). |
| Last Update Date |
1/13/2020 |
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |
| Provider Gender Code |
F |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
| Healthcare Provider Taxonomy Code 1 |
106S00000X |
|
| Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
| Is Sole Proprietor |
N |
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |