Healthcare Provider Details

I. General information

NPI: 1952910036
Provider Name (Legal Business Name): NADARE SAHIM ALWAN FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4267 TRANSIT RD
WILLIAMSVILLE NY
14221-7205
US

IV. Provider business mailing address

25 COUNTRYSIDE LN
ORCHARD PARK NY
14127-1316
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-0798
  • Fax:
Mailing address:
  • Phone: 716-228-3462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF346091
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF346091
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: