Provider Demographics
NPI:1437114709
Name:WORRELL, SARAH G K (CNM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:G K
Last Name:WORRELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14204-2275
Mailing Address - Country:US
Mailing Address - Phone:716-847-6610
Mailing Address - Fax:716-854-3052
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:2006-04-19
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000206-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3919690OtherCIGNA HEALTH CARE
NY000560045004OtherBLUECROSSBLUESHIELDWNY
NY83-01350OtherUNITED HEALTH CARE
NY01474675Medicaid
NY040426000417OtherFIDELIS
NY5008736OtherINDEPENDENT HEALTH ASSOC
NY1899953OtherGHI
NY0007479197OtherAETNA
NY00010253801OtherUNIVERA
NY3919690OtherCIGNA HEALTH CARE
NYDD4318Medicare ID - Type Unspecified