Healthcare Provider Details

I. General information

NPI: 1639137904
Provider Name (Legal Business Name): DONNA SAYADOFF-FLAHERTY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 STATE STREET
NUNDA NY
14517-9785
US

IV. Provider business mailing address

PO BOX 601 10869 RTE 36 SOUTH
DANSVILLE NY
14437-0601
US

V. Phone/Fax

Practice location:
  • Phone: 585-468-2528
  • Fax: 585-468-5424
Mailing address:
  • Phone: 585-335-3416
  • Fax: 585-335-8695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number004381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: