Provider Demographics
NPI:1528099298
Name:KORACH, A. SINIA (NP)
Entity type:Individual
Prefix:
First Name:A.
Middle Name:SINIA
Last Name:KORACH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2875 UNION RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1470
Mailing Address - Country:US
Mailing Address - Phone:716-706-2034
Mailing Address - Fax:716-706-2035
Practice Address - Street 1:397 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-2275
Practice Address - Country:US
Practice Address - Phone:716-847-6610
Practice Address - Fax:716-854-3052
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY380521363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426001219OtherFIDELIS
NY00026552907OtherUNIVERA HEATLHCARE
NY000560130001OtherBLUE CROSS OF WNY
NY9511923OtherINDEPENDENT HEALTH