MEDICARE: SALLY ANN NORMAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	015362	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000527354002	OTHER	NY	HEALTH INTEGRATED
2	11515521	OTHER	NY	CAQH
3	00026192402	OTHER	NY	UNIVERA HEALTHCARE
4	6111583	OTHER	NY	INDEPENDENT HEALTH
5	000527354002	OTHER	NY	BC/BS OF WNY

General Provider Information

NPI Number	:	1346246816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLY ANN NORMAN PHD

Provider Business Mailing Address
First Line	:	2360 SWEET HOME RD STE 1
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-2331
Country	:	US
Telephone Number	:	716-622-6237
Fax Number	:	844-907-2998

Provider Business Practice Location Address
First Line	:	2360 SWEET HOME RD STE 1
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-2331
Country	:	US
Telephone Number	:	716-622-6237
Fax Number	:	844-907-2998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	01/14/2025

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Directions to “ SALLY ANN NORMAN PHD” Practice Location

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