Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Cardinale, Chet Acupuncture Cardinale, Chet 1046 Walden Ave Cheektowaga NY 14211 Erie 7168934664

Fu, Amy May Acupuncture Fu, Amy May 946 Maple Rd Williamsville NY 14221 Erie 7169829191

Fu, Zhipei Acupuncture Fu's Acuputure PLLC 19 Limestone Dr Ste 6 Williamsville NY 14221 Erie 7166336288

Fu, Zhipei Acupuncture Fu's Acuputure PLLC 220 Redtail Ste 4 Orchard Park NY 14127 Erie 7166336288

Grobelny, Robert M. Acupuncture Grobelny, Robert 856 Ridge Rd Lackawanna NY 14218 Erie 7166519011

Iannaccone, Marc R. Acupuncture Iannaccone, Marc 656 Elmwood Ave Buffalo NY 14222 Erie 7168830515

Lau, Herbert Acupuncture Lau, Herbert 5859 Transit Rd East Amherst NY 14051 Erie 7166881768

Li, Yuehui Acupuncture Li, Yuehui 4229 Maple Rd Amherst NY 14226 Erie 7168038899

McDonell, Jonathan W. Acupuncture A.D.I.O. Acupuncture & Wellness Center 704 Beach Rd Cheektowaga NY 14225 Erie 7169840899

O Neil, Mary M. Acupuncture Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Santasiero, Ronald P. Acupuncture Santasiero, Ronald 4535 Southwestern Blvd Ste 801 Hamburg NY 14075 Erie 7166466075

Schilling, Andrea M. Acupuncture WNY Acupuncture Works PLLC 1961 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7162768866

Giordano, Paul B. Addiction Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Moffat, Douglas Addiction Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168984884

Moffat, Douglas Addiction Psychiatry UB Family Medicine Inc 462 Grider St Buffalo NY 14215 Erie 7168983676

Burstein, Gale R. Adolescent Medicine University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 6 Amherst NY 14226 Erie 7168781081

Burstein, Gale R. Adolescent Medicine University at Buffalo Pediatric Associates Inc 140 Hodge Ste 1a 1b Buffalo NY 14222 Erie 7168781081

Burstein, Gale R. Adolescent Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168781081

Burstein, Gale R. Adolescent Medicine Kaleida Health 461 William St Town Garden Pediatric Clinic Buffalo NY 14206 Erie 7168521578

Burstein, Gale R. Adolescent Medicine Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168587687

Burstein, Gale R. Adolescent Medicine Kaleida Health 125 Hodge St Buffalo NY 14222 Erie 7168781560

Burstein, Gale R. Adolescent Medicine University at Buffalo Pediatric Associates Inc Womens Childrens Hosp Of Bfl 219 Bryant St Buffalo NY 14222 Erie 7168781081

Condino, Dalinda A. Adolescent Medicine University at Buffalo Pediatric Associates Inc Womens and Childrens Hosp Of Bfl 219 Bryant St Buffalo NY 14222 Erie 7168781081

Condino, Dalinda A. Adolescent Medicine Kaleida Health 125 Hodge St Buffalo NY 14222 Erie 7168787488

Condino, Dalinda A. Adolescent Medicine University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168781081

Condino, Dalinda A. Adolescent Medicine Kaleida Health 140 Hodge St Buffalo NY 14222 Erie 7168781081

Condino, Dalinda A. Adolescent Medicine Kaleida Health 461 William St Buffalo NY 14206 Erie 7168521578

Condino, Dalinda A. Adolescent Medicine University at Buffalo Pediatric Associates Inc PO Box 2113 Buffalo NY 14222 Erie 7168781570

Condino, Dalinda A. Adolescent Medicine Academic Medicine Services 300 Linwood Ave Buffalo NY 14209 Erie 7169619400

Siegel, Myron R. Adolescent Medicine East Aurora Pediatrics Pc 94 Olean St Ste 210 East Aurora NY 14052 Erie 7166520237

Akl, Michel E. Allergy & Immunology Akl, Michel 564 Niagara St Buffalo NY 14201 Erie 7163737440

Ambrus Jr, Julian L. Allergy & Immunology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592985

Ambrus Jr, Julian L. Allergy & Immunology Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168592985

Cumella, James C. Allergy & Immunology University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787105

Cumella, James C. Allergy & Immunology Allergy & Asthma Assoc Of Wny Pc 333 International Dr Ste B1 Williamsville NY 14221 Erie 7166335277

Cumella, James C. Allergy & Immunology Advanced Allergy and Asthma Care of WNY PC 333 International Dr Ste B1 Buffalo NY 14221 Erie 7166335277

Cumella, James C. Allergy & Immunology Advanced Allergy and Asthma Care of WNY PC 100 High St Ste D3 Buffalo NY 14203 Erie 7168592524

Cumella, James C. Allergy & Immunology Kaleida Health 100 High St Ste D3 Buffalo NY 14203 Erie 7168592524

Cumella, James C. Allergy & Immunology University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787105

Cumella, James C. Allergy & Immunology Allergy & Asthma Assoc Of Wny Pc 333 International Dr Ste B1 Williamsville NY 14221 Erie 7166335277

Donovan Antalek, Kathleen Allergy & Immunology Buffalo Amherst Allergy Assoc 500 Corp Pkwy Ste 100 Amherst NY 14226 Erie 7166310380

Fanning, Michael J. Allergy & Immunology Buffalo Amherst Allergy Assoc 500 Corp Pkwy Ste 100 Buffalo NY 14226 Erie 7166310380

Grabiec, Steven V. Allergy & Immunology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787105

Grabiec, Steven V. Allergy & Immunology University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787105

Grabiec, Steven V. Allergy & Immunology University at Buffalo Pediatric Associates Inc 3580 Sheridan Dr Amherst NY 14226 Erie 7168787105

Grabiec, Steven V. Allergy & Immunology University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787105

Green, Andrew W. Allergy & Immunology Andrew W Green, MD & Rita R Sloan, MD 3615 Seneca St Buffalo NY 14224 Erie 7166752660

Honeine, Roland A. Allergy & Immunology Andrew W Green, MD & Rita R Sloan, MD 3615 Seneca St West Seneca NY 14224 Erie 7166752660

Lehman, Heather Allergy & Immunology University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787105

Lehman, Heather Allergy & Immunology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787105

Lehman, Heather Allergy & Immunology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787105

Lewis, Fred H. Allergy & Immunology University at Buffalo Pediatric Associates Inc 3580 Sheridan Dr Amherst NY 14226 Erie 7168787105

Lewis, Fred H. Allergy & Immunology University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787105

Lewis, Fred H. Allergy & Immunology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787105

Lewis, Fred H. Allergy & Immunology University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787105

Lillie, Madeline A. Allergy & Immunology Buffalo Amherst Allergy Assoc 500 Corp Pkwy Ste 100 Amherst NY 14226 Erie 7166310380

Liu Helm, Aries Y. Allergy & Immunology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301137

Liu Helm, Aries Y. Allergy & Immunology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301130

Liu Helm, Aries Y. Allergy & Immunology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301130

Melgar, Luis Allergy & Immunology Luis Melgar Md 5893 Camp Rd Ste 3 Hamburg NY 14075 Erie 7166487401

Melgar, Luis Allergy & Immunology Luis Melgar Md 5775 Maelou Dr Hamburg NY 14075 Erie 7166482820

Melgar, Luis Allergy & Immunology Luis Melgar Md 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Najar, Gulam M. Allergy & Immunology Ehrenreich & Najar 30 Amsterdam Ave Amherst NY 14226 Erie 7168377424

Packianathan, Nalini B. Allergy & Immunology Kaleida Health 100 High St Ste D 3 Buffalo NY 14203 Erie 7168592524

Packianathan, Nalini B. Allergy & Immunology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Packianathan, Nalini B. Allergy & Immunology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301130

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Packianathan, Nalini B. Allergy & Immunology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301130

Packianathan, Nalini B. Allergy & Immunology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301130

Packianathan, Nalini B. Allergy & Immunology Advanced Allergy and Asthma Care of WNY PC 333 International Dr Ste B1 Williamsville NY 14221 Erie 7166335277

Ramesh, Sujatha Allergy & Immunology University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787105

Ramesh, Sujatha Allergy & Immunology University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Buffalo NY 14222 Erie 7168787105

Ramesh, Sujatha Allergy & Immunology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 Buffalo NY 14226 Erie 7168787258

Ramesh, Sujatha Allergy & Immunology University at Buffalo Pediatric Associates Inc 3580 Sheridan Dr Amherst NY 14226 Erie 7168787105

Ramesh, Sujatha Allergy & Immunology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787105

Rockoff, Jeffrey B. Allergy & Immunology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787105

Rockoff, Jeffrey B. Allergy & Immunology Jeffrey B ROckoff MD PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168748980

Rockoff, Jeffrey B. Allergy & Immunology University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787105

Rockoff, Jeffrey B. Allergy & Immunology University at Buffalo Pediatric Associates Inc 219 Bryant Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787105

Sands, Mark F. Allergy & Immunology Academic Medicine Services 100 High St Buffalo NY 14209 Erie 7168595600

Schwartz, Stanley A. Allergy & Immunology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Schwartz, Stanley A. Allergy & Immunology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592985

Schwartz, Stanley A. Allergy & Immunology Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168592885

Sloan, Rita R. Allergy & Immunology Andrew W Green, MD & Rita R Sloan, MD 3615 Seneca St Buffalo NY 14224 Erie 7166752660

Srivastava, Maya D. Allergy & Immunology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591250

Arshad, Ayesha Anatomic & Clinical Path VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Cai, Donghong Anatomic & Clinical Path University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Cai, Donghong Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Chopra, Usha G. Anatomic & Clinical Path Southtowns Gastroenterology, PLLC 3065 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166779220

Crossland, David M. Anatomic & Clinical Path VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Geary, William A. Anatomic & Clinical Path Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Geary, William A. Anatomic & Clinical Path Western New York Urology Associates LLC 55 Spindrift Dr Ste 240 Williamsville NY 14221 Erie 7166319600

Geary, William A. Anatomic & Clinical Path Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Gonzalez Fernandez, Frederico Anatomic & Clinical Path VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Habib, Fadi Anatomic & Clinical Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Haim, Robert V. Anatomic & Clinical Path University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Haim, Robert V. Anatomic & Clinical Path University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Haim, Robert V. Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Haim, Robert V. Anatomic & Clinical Path University at Buffalo Pathologists PC 115 Flint Rd Williamsville NY 14221 Erie 7166267200

Hannahoe, Brigid M. Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Higgs, Donald E. Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Higgs, Donald E. Anatomic & Clinical Path University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Higgs, Donald E. Anatomic & Clinical Path Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Hwang, Helena Anatomic & Clinical Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kandel Amatya, Sirisa Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Kandel Amatya, Sirisa Anatomic & Clinical Path University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Liu, Weiguo Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Liu, Weiguo Anatomic & Clinical Path University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Longo, Stacey Anatomic & Clinical Path Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Longo, Stacey Anatomic & Clinical Path Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265240

Merzianu, Mihai Anatomic & Clinical Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Paterson, Joyce M. Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Pokharel, Saraswati Anatomic & Clinical Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Rong, Rong Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168565600

Rong, Rong Anatomic & Clinical Path University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Satchidanand, Sateesh K. Anatomic & Clinical Path Southtowns Gastroenterology, PLLC 3065 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166779220

Schrecengost, John E. Anatomic & Clinical Path Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Schrecengost, John E. Anatomic & Clinical Path Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Schrecengost, John E. Anatomic & Clinical Path Western New York Urology Associates LLC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166483415

Slate II, Donald M. Anatomic & Clinical Path Eastern Great Lakes Pathology Pc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Soofi, Yousef Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Zhang, Nan Anatomic & Clinical Path University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Zhou, Young T. Anatomic & Clinical Path Southtowns Gastroenterology, PLLC 3065 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166779220

Azabdaftari, Gissou Anatomic Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Barcos, Maurice P. Anatomic Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Baysal, Bora E. Anatomic Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Dvoretsky, Philip M. Anatomic Pathology Eastern Great Lakes Pathology Pc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Frisch, Nora K. Anatomic Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Frisch, Nora K. Anatomic Pathology University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Frisch, Nora K. Anatomic Pathology University at Buffalo Pathologists PC 115 Flint Rd Williamsville NY 14221 Erie 7166267200

Frisch, Nora K. Anatomic Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Frisch, Nora K. Anatomic Pathology University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Gonzalez Fernandez, Frederico Anatomic Pathology University at Buffalo Pathologists PC 100 High St Neurosurgery Dept Buffalo NY 14203 Erie 7168595600

Page 2 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Gonzalez Fernandez, Frederico Anatomic Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Morrison, Carl D. Anatomic Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Adragna, Michael G. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Alker, John L. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168367510

Alker, John L. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Alker, John L. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Alvarez Perez, Amy B. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Anthone, David A. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Anthone, David A. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Anthone, David A. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Anthone, David A. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Anunta, Boonchuay Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Anunta, Boonchuay Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Armstrong, James B. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Fl 2 Buffalo NY 14222 Erie 7168787701

Armstrong, James B. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Auguste, Madeleine Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Williamsville NY 14221 Erie 7166321088

Auguste, Madeleine Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Bahk, Benedictus S. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Bahk, Benedictus S. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Bahk, Benedictus S. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Bahk, Benedictus S. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Bahk, Benedictus S. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168597100

Bancroft, George H. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Bancroft, George R. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Barber Faller, Julia Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Barlog, Elizabeth Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Barlow, Jared C. Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Berkun, Rose Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Berkun, Rose Anesthesiology Berkun, Rose 2500 Kensington Ave Amherst NY 14226 Erie 7168391700

Berkun, Rose Anesthesiology Berkun, Rose 495 International Dr Williamsville NY 14221 Erie 7165653999

Bhayani, Hansa H. Anesthesiology Anesthesia Consultant Assoc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Bhayani, Hansa H. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Buffalo NY 14221 Erie 7168398645

Bhayani, Hansa H. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Bhayani, Hansa H. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Bhayani, Hansa H. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168367510

Biersbach, Bret H. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Burdick, James P. Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Burns, Terrence R. Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Burns, Terrence R. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Burns, Terrence R. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Burns, Terrence R. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Burns, Terrence R. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Burrows, Frederick A. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Burrows, Frederick A. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Cabak Borovcanin, Zana Anesthesiology VA Western NY Health Med Ctr 100 High St Buffalo NY 14203 Erie 7168592226

Cameron, Yoteen M. Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Carpenter Wolf, Laura J. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Carpenter Wolf, Laura J. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Carpenter Wolf, Laura J. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Carpenter Wolf, Laura J. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Chen, Daxin Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874069

Chen, Daxin Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Chen, Daxin Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Chen, Daxin Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Chen, Daxin Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Chudy III, Max R. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Fl 2 Buffalo NY 14222 Erie 7168787701

Croucher, Thomas W. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm And Carlton Streets Buffalo NY 14263 Erie 7168452300

Davis, Howard I. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Davis, Howard I. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

DeLeon Casasola, Oscar A. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

DePlato, Anthony J. Anesthesiology Anesthesia Medical Consultants, PLLC 550 Orchard Park Rd Bldg B West Seneca NY 14224 Erie 7166774400

DePlato, Anthony J. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983436

Devgun, Ravinder K. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Diakun, Thomas A. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Buffalo NY 14221 Erie 7168398645

Diakun, Thomas A. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Diakun, Thomas A. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Diakun, Thomas A. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Divan, Kishore V. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Divan, Kishore V. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Divan, Kishore V. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Divan, Kishore V. Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Divan, Kishore V. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Dombrowski, Laura Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168367510

Dombrowski, Laura Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Dombrowski, Laura Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Buffalo NY 14221 Erie 7166346100

Dombrowski, Laura Anesthesiology Parkside Anesthesia Associates PC 2121 Main St Ste 209 Buffalo NY 14214 Erie 7168367510

Eckler, Justin R. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Eckler, Justin R. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Elgersma, Chad C. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Elgersma, Chad C. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Elgersma, Chad C. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168367510

Ellie Sr, John Anesthesiology Anesthesia Affiliates Pc 2605 Harlem Rd Buffalo NY 14225 Erie 7168988959

Everett, Charles W. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Everett, Charles W. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Fan, Liang Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Fan, Liang Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Fan, Liang Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Fan, Liang Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Fan, Liang Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Fattouch Saikali, Rita Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Fattouch Saikali, Rita Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Fattouch Saikali, Rita Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Fattouch Saikali, Rita Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Fattouch Saikali, Rita Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Fattouch Saikali, Rita Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Fattouch Saikali, Rita Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Fattouch, Hany Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Fattouch, Hany Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Feldman, Doron Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Filadora III, Victor A. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Foramiglio, Marco C. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Foramiglio, Marco C. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Foramiglio, Marco C. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Foramiglio, Marco C. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Foster, James M. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Franckowiak, Melissa M. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Franckowiak, Melissa M. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Franckowiak, Melissa M. Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Franckowiak, Melissa M. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Franckowiak, Melissa M. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Franckowiak, Melissa M. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Franckowiak, Melissa M. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Franckowiak, Melissa M. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Franckowiak, Melissa M. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Fullone, Joseph S. Anesthesiology Anesthesia Affiliates Pc 2605 Harlem Rd Buffalo NY 14225 Erie 7168988959

Gambacorta, Katherine A. Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Williamsville NY 14221 Erie 7166321088

Gambacorta, Katherine A. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Gawron, Nicole M. Anesthesiology VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7168983000

Gawron, Nicole M. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Gawron, Nicole M. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Gladysz, Stephen C. Anesthesiology Abbott Anesthesiologist Assoc 515 Abbott Rd Ste 410 Buffalo NY 14220 Erie 7168266628

Gladysz, Stephen C. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Goodnough, Stephen Anesthesiology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592260

Gopalakrishnan, Bhaskar Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Gopalakrishnan, Bhaskar Anesthesiology Parkside Anesthesia Associates PC 2121 Main St Ste 209 Buffalo NY 14214 Erie 7168367510

Gopalakrishnan, Bhaskar Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Gothgen, Nicole M. Anesthesiology Great Lakes Anesthesiology Elm and Carlton Streets Buffalo NY 14263 Erie 7168452300

Gothgen, Nicole M. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Gothgen, Nicole M. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Grande, Jon W. Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Grande, Jon W. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Grande, Jon W. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Page 4 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Grande, Jon W. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Grande, Jon W. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Gulati, Sudarshan K. Anesthesiology S K Gulati MD PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Gulati, Sudarshan K. Anesthesiology S K Gulati MD PC 495 International Dr Williamsville NY 14221 Erie 7165653999

Gunderia, Mita D. Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Guntupalli, Rama M. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Guntupalli, Rama M. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Guo, Xiaojun Anesthesiology Endion Hospitalist of Western New York PC 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Harvey, Nishi S. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Hemmingson, Daniel T. Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Williamsville NY 14221 Erie 7166321088

Hemmingson, Daniel T. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Hinds III, Ralph W. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Hinds III, Ralph W. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Hinds III, Ralph W. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Dept Of Surg Buffalo NY 14209 Erie 7168874224

Hinds III, Ralph W. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Hitt, James M. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hitt, James M. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hitt, James M. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Houck, James P. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Hsu, Bernard H. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hsu, Bernard H. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hudson, Iris M. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Irrera, Joseph N. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Irrera, Joseph N. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Irrera, Joseph N. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Irrera, Joseph N. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Jensen, Erik J. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7166344798

Jensen, Erik J. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Jones, Kenyon W. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Justis, Gina B. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Justis, Gina B. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7166344798

Kahn, Douglas G. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Kamisetti, Dhananjaya Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Kamisetti, Dhananjaya Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Kamisetti, Dhananjaya Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874800

Kamisetti, Dhananjaya Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Kamisetti, Dhananjaya Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Karas, Paul B. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Karas, Paul B. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Karas, Paul B. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Karas, Paul B. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Kaye, Robert D. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Kaye, Robert D. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Knorz, David W. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Knorz, David W. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Knorz, David W. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Knorz, David W. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Knorz, David W. Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Knorz, David W. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Kolesnikov, Sergei Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Kolesnikov, Sergei Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Kolesnikov, Sergei Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Kolesnikov, Sergei Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Kolesnikov, Sergei Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Koneru, Lakshmana R. Anesthesiology Abbott Anesthesiologist Assoc 515 Abbott Rd Ste 410 Buffalo NY 14220 Erie 7168266628

Kotob, Fayez Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Kotob, Fayez Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Kotob, Fayez Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Kotob, Fayez Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Krish, Siva Anesthesiology Anesthesia Consultant Assoc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Krish, Siva Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Krish, Siva Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Krish, Siva Anesthesiology Anesthesia Consultant Assoc 2333 Elmwood Ave Ste 2 Kenmore NY 14217 Erie 7168741098

Kruglov, Alexander Y. Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Kruglov, Alexander Y. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Kruglov, Alexander Y. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Page 5 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kruglov, Alexander Y. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Kruglov, Alexander Y. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Kruglov, Alexander Y. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Kurek, Carlos J. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Kurek, Carlos J. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Kurek, Carlos J. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Kurek, Carlos J. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Kurek, Luisa S. Anesthesiology VA Western NY Health Med Ctr 100 High St Buffalo NY 14203 Erie 7168592226

Kurek, Luisa S. Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Lee, Jae S. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Lee, Jae S. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Lee, Lori A. Anesthesiology Abbott Anesthesiologist Assoc 515 Abbott Rd Ste 410 Buffalo NY 14220 Erie 7168266628

Lerman, Jerrold Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Li, Li Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Lovrincevic, Igor Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Lovrincevic, Mirjana Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Lucas, Stefan Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Madden, Michael M. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Madden, Michael M. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Mahoney, Elizabeth L. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Mahoney, Elizabeth L. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Mahoney, Elizabeth L. Anesthesiology Anesthesia Medical Consultants, PLLC 550 Orchard Park Rd Ste 101b Buffalo NY 14224 Erie 7166344798

Mahoney, Elizabeth L. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Mangan, David F. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbot Rd Buffalo NY 14220 Erie 7168266628

Mapes, Renee M. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Mapes, Renee M. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Buffalo NY 14225 Erie 7168367510

Mapes, Renee M. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Mapes, Renee M. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Mapes, Renee M. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Marino, Michael B. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Marino, Michael B. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Fl 2 Buffalo NY 14222 Erie 7168787701

Markovic, Sinisa Anesthesiology VA Western NY Health Med Ctr 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963816

Markovic, Sinisa Anesthesiology VA Western NY Health Med Ctr 100 High St Buffalo NY 14203 Erie 7168592226

Markovic, Sinisa Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Markovic, Sinisa Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Massucci, Joanne M. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Massucci, Joanne M. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Massucci, Joanne M. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Massucci, Joanne M. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

McClintick, Elizabeth A. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

McClintick, Elizabeth A. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

McClure, Lindsay J. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

McClure, Lindsay J. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168367510

McClure, Lindsay J. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

McMahon, Kevin F. Anesthesiology Ambulatory Medical Anesthesia Services PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Mijatovic, Ljiljana Anesthesiology Tasneem J Shah MD PC 2695 Harlem Rd Buffalo NY 14225 Erie 7168915992

Mijatovic, Ljiljana Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Mireles, Ramiro Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Moshides, Steven J. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Mukkamala, Krishna P. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Mukkamala, Krishna P. Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Mukkamala, Krishna P. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Mukkamala, Krishna P. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Mukkamala, Krishna P. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Mukkamala, Somasekhara R. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Mukkamala, Somasekhara R. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Mukkamala, Somasekhara R. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Mukkamala, Somasekhara R. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Myers, David P. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Myers, David P. Anesthesiology Anesthesia Medical Consultants, PLLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166344798

Myers, David P. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Myers, David P. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Nader, Nader D. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Nader, Nader D. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Nader, Nader D. Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Nazareth, Helen M. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Page 6 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Nazareth, Helen M. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Streets Buffalo NY 14263 Erie 7168452300

Nebbia, Stephan P. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Fl 2 Buffalo NY 14222 Erie 7168787701

O Leary, Kathleen A. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

O'Connor, Thomas A. Anesthesiology Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Park, Kathleen J. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Parlato III, Salvatore J. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Pechenik, Boris Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Pechenik, Boris Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Peer, Matthew G. Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Buffalo NY 14221 Erie 7166321088

Peer, Matthew G. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Peer, Matthew G. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Buffalo NY 14221 Erie 7165686633

Peer, Matthew G. Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Buffalo NY 14221 Erie 7166321088

Peer, Matthew G. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Peppriell, James E. Anesthesiology Peppriell, James 224 E Main St Springville NY 14141 Erie 7165922871

Peppriell, James E. Anesthesiology Anesthesia Consultant Assoc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Perez Cartagena, Pedro A. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Plata, Edward T. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Plata, Edward T. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Plata, Edward T. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Plata, Edward T. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Plotkin, Scott N. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7166344798

Plotkin, Scott N. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Podebryi, Maria Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Podebryi, Maria Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Podebryi, Maria Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Podebryi, Maria Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Porhomayon, Jahan Anesthesiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Quinlivan Jr, John K. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Quinlivan Jr, John K. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Quinlivan Jr, John K. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Quinlivan Jr, John K. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Raczka, Michelle C. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Raczka, Michelle C. Anesthesiology Great Lakes Anesthesiology Elm and Carlton Sts Buffalo NY 14221 Erie 7168452300

Ramsdell, Robert J. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Ramsdell, Robert J. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Ramsdell, Robert J. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Ramsdell, Robert J. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Ramsdell, Robert J. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Reed, Karen S. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983436

Rutkowski, Thaddeus C. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Rutkowski, Thaddeus C. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Rutkowski, Thaddeus C. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Rutkowski, Thaddeus C. Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Rutkowski, Thaddeus C. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Sacks, Andrew J. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Sacks, Andrew J. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Sands Jr, Robert P. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Sands Jr, Robert P. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Schlesinger, Michelle L. Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Williamsville NY 14221 Erie 7166321088

Schlesinger, Michelle L. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Shah, Tasneem J. Anesthesiology Shah, Tasneem J. 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Shah, Tasneem J. Anesthesiology Harlem Anesthesia PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Shah, Tasneem J. Anesthesiology Shah, Tasneem J. 2157 Main St Buffalo NY 14214 Erie 7168367510

Shah, Tasneem J. Anesthesiology Sarbjit Singh PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Shah, Tasneem J. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168367510

Shah, Tasneem J. Anesthesiology Tasneem J Shah MD PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Shah, Tasneem J. Anesthesiology Tasneem J Shah MD PC 303 Sterling Dr Orchard Park NY 14127 Erie 7167120600

Shapiro, David I. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Shapiro, David I. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Sharma, Suresh C. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Sharma, Suresh C. Anesthesiology Buffalo Anesthesia Assoc Pc 4510 Main St Ste 105 Amherst NY 14226 Erie 7168860444

Sharma, Suresh C. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Shin, Kwang H. Anesthesiology Shin, Kwang H. 6245 Sheridan Dr Williamsville NY 14221 Erie 7162507240

Shin, Kwang H. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Shin, Kwang H. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Shin, Kwang H. Anesthesiology Parkside Anesthesia Associates PC 2605 Harlem Rd Buffalo NY 14225 Erie 7168367510

Page 7 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Sillart, Douglas R. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Sillart, Douglas R. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Sillart, Douglas R. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Sillart, Douglas R. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Silva, Gerard Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Simkins, Jennifer L. Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Williamsville NY 14221 Erie 7166321088

Simkins, Jennifer L. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Slaughter, Stephanie A. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Slaughter, Stephanie A. Anesthesiology Maple-Gate Anesthesiologists 30 South Cayuga Rd Williamsville NY 14221 Erie 7166321088

Snyder, Glenn J. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Snyder, Glenn J. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Snyder, Glenn J. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Snyder, Glenn J. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Snyder, Glenn J. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Sroka, Raymond D. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Stern, Mont P. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Stern, Mont P. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Stern, Mont P. Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Stern, Mont P. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Stern, Mont P. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Stevens III, John B. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Stevens III, John B. Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Stevens III, John B. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Stevens III, John B. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Stevens III, John B. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Stevens III, John B. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Syed, Masroor A. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Syed, Masroor A. Anesthesiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983536

Tandoc, Merle N. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Tandoc, Merle N. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Tauriello, Carin M. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Tick, Robert C. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Tobias, Gregory V. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Toufexis, George Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Toufexis, George Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Toufexis, George Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Toufexis, George Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Toufexis, George Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Turco, George Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Tynski, Maciej T. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Tynski, Maciej T. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Tynski, Maciej T. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Umfrey, David K. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Umfrey, David K. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Velasquez, Bernardino R. Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7166321088

Velasquez, Bernardino R. Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7166321088

Velasquez, Bernardino R. Anesthesiology Maple-Gate Anesthesiologists 30 S Cayuga Rd Williamsville NY 14221 Erie 7166321088

Velasquez, Bernardino R. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Velasquez, Bernardino R. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Velasquez, Norma V. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Velasquez, Norma V. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168367510

Velasquez, Norma V. Anesthesiology Harlem Anesthesia PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Velasquez, Norma V. Anesthesiology Kaleida Health 160 Rollingwood Williamsville NY 14221 Erie 7168874745

Virk, Amarjit S. Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Virk, Amarjit S. Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Virk, Amarjit S. Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Virk, Navyugjit Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Vivekanandan, Nallasivam Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Vivekanandan, Nallasivam Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 14203 Erie 7166321088

Vivekanandan, Nallasivam Anesthesiology Maple-Gate Anesthesiologists 1263 Delaware Ave Buffalo NY 14209 Erie 7168858255

Vivekanandan, Nallasivam Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874745

Vivekanandan, Nallasivam Anesthesiology Maple-Gate Anesthesiologists 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Vogt Sr, David G. Anesthesiology Harlem Anesthesia PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Vogt Sr, David G. Anesthesiology Sarbjit Singh PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Vogt Sr, David G. Anesthesiology Parkside Anesthesia Associates PC 2333 Elmwood St Kenmore NY 14217 Erie 7168741098

Wang, Alan Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Page 8 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Wang, Alan Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Wang, Alan Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Wang, Alan Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Watson, Eileen Anesthesiology Great Lakes Anesthesiology 219 Bryant St FL 2 Buffalo NY 14222 Erie 7168787701

Watson, Michael S. Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Watson, Michael S. Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7168367510

Watson, Michael S. Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Watson, Michael S. Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Watt, Stacey A. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Weinberg, Michael B. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Fl 2 Buffalo NY 14222 Erie 7168787701

Werth, Christopher E. Anesthesiology Anesthesia Medical Consultants, PLLC 462 Grider St Buffalo NY 14215 Erie 7168983549

Wilber, Monte D. Anesthesiology Abbott Anesthesiologist Assoc 515 Abbott Rd Ste 410 Buffalo NY 14220 Erie 7168266628

Winkowski, Anthony J. Anesthesiology Abbott Anesthesiologist Assoc 565 Abbott Rd Buffalo NY 14220 Erie 7168266628

Yarussi, Anthony T. Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Younger, Charles M. Anesthesiology Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Yu, Ernesto L. Anesthesiology Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Yu, Ernesto L. Anesthesiology Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Zafar, Jill Anesthesiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Zelenov, Victor Anesthesiology Maple-Gate Anesthesiologists 215 Klein Rd Williamsville NY 14221 Erie 7166321088

Zelenov, Victor Anesthesiology Maple-Gate Anesthesiologists 875 Ellicott St Buffalo NY 14203 Erie 7167482000

Zelenov, Victor Anesthesiology Maple-Gate Anesthesiologists 1540 Maple Rd Williamsville NY 14221 Erie 7165686633

Zelenov, Victor Anesthesiology Maple-Gate Anesthesiologists 3 Gates Cir Buffalo NY 14209 Erie 7168874241

Zelenov, Victor Anesthesiology Maple-Gate Anesthesiologists 100 High St Buffalo NY 142031126 Erie 7166321088

Zhang, Junkui Anesthesiology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Zhang, Junkui Anesthesiology Parkside Anesthesia Associates PC 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Zhang, Junkui Anesthesiology Parkside Anesthesia Associates PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168398645

Zhang, Junkui Anesthesiology Parkside Anesthesia Associates PC 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Aramini, Lauren L. Audiology Accura Audiology PLLC 6645 Main St Ste B Williamsville NY 14221 Erie 7166330721

Aramini, Lauren L. Audiology Accura Audiology PLLC 2671 Halrem Rd Cheektowaga NY 14225 Erie 7166330721

Baker Kuta, Andrea N. Audiology Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Baker Kuta, Andrea N. Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7166680233

Baker Kuta, Andrea N. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Baker Kuta, Andrea N. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7166497801

Baker Kuta, Andrea N. Audiology Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Ball, Nicole L. Audiology Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502000

Ball, Nicole L. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Ball, Nicole L. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Ball, Nicole L. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Ball, Nicole L. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Ball, Nicole L. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Ball, Nicole L. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Baumgartner, Nicole E. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Baumgartner, Nicole E. Audiology Genesee Hearing Services 61 Wehrle Dr Amherst NY 14225 Erie 7168376213

Baumgartner, Nicole E. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Baumgartner, Nicole E. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Baumgartner, Nicole E. Audiology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301191

Baumgartner, Nicole E. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301191

Baumgartner, Nicole E. Audiology Audiology Service Associates, P.C. 1150 Youngs Rd Ste 209 Williamsville NY 14221 Erie 7166337210

Baumgartner, Nicole E. Audiology Audiology Service Associates, P.C. 103 Niagara St Tonawanda NY 14150 Erie 7166925605

Bernstein, Jill C. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Bernstein, Jill C. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Bernstein, Jill C. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Bernstein, Jill C. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Bernstein, Jill C. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Bernstein, Jill C. Audiology Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502045

Bernstein, Jill C. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Brandon, Alison M. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Brandon, Alison M. Audiology Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Brandon, Alison M. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Brinkman, Janet C. Audiology Diversified Services for OT PT SLP and Audiology LLC 725 Orchard Pk Rd Ste E West Seneca NY 14224 Erie 7166743741

Brinkman, Janet C. Audiology Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Brinkman, Janet C. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Brinkman, Janet C. Audiology Diversified Services for OT PT SLP and Audiology LLC 2430 N Forest Rd Ste 150 Getzville NY 14068 Erie 7166367613

Brinkman, Janet C. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7166497801

Brinkman, Janet C. Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 Transit Rd Elma NY 14059 Erie 7166680233

Carlone, Kerry A. Audiology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Page 9 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Cline, Carrie D. Audiology Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Cline, Carrie D. Audiology Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Buffalo NY 14221 Erie 7163621552

Cline, Carrie D. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719883

Cline, Carrie D. Audiology Elmwood Health Center 3040 Amsdell Rd Hamburg NY 14075 Erie 7166497801

Cline, Carrie D. Audiology Elmwood Health Center 2565 Elmwood Ave Kenmore NY 14217 Erie 7168719883

Cline, Carrie D. Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7166680233

Cline, Carrie D. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7166497801

Costello, Laura M. Audiology Aurora Audiology & Speech Assoc Inc 97 Hamburg St East Aurora NY 14052 Erie 7166526464

Dube, Michelle M. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Dube, Michelle M. Audiology Buffalo Hearing & Speech 5225 SHERIDAN DR Buffalo NY 14221 Erie 7162048680

Dube, Michelle M. Audiology Buffalo Hearing & Speech 1026 UNION DR Buffalo NY 14224 Erie 7165581105

Eisen, Ashley J. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Eisen, Ashley J. Audiology Paul R Young MD PLLC 4955 N Bailey Ave Ste 202 Amherst NY 14226 Erie 7168328500

Eisen, Ashley J. Audiology Buffalo Hearing & Speech 55225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Flanagan, Kevin G. Audiology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Flanagan, Kevin G. Audiology Lake Shore Audiology PC 3085 Southwestern Blvd Ste 103 Orchard Park NY 14127 Erie 7166744188

Gioia, Laura G. Audiology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Graf, Christine J. Audiology Amherst Audiological Services PC 315 Alberta Dr Ste 105 Amherst NY 14226 Erie 7168385360

Gravius, Jessica L. Audiology Audiology Service Associates, P.C. 103 Niagara St Tonawanda NY 14150 Erie 7166925605

Gravius, Jessica L. Audiology Audiology Service Associates, P.C. 1150 Youngs Rd Ste 209 Williamsville NY 14221 Erie 7166337210

Gruttadauria, Salvatore A. Audiology Salvatore Gruttadauria 17 Limestone Dr Ste 5 Buffalo NY 14221 Erie 7163621552

Gruttadauria, Salvatore A. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719883

Gruttadauria, Salvatore A. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7166497801

Gruttadauria, Salvatore A. Audiology Salvatore Gruttadauria 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7166680233

Gullo II, Joseph A. Audiology Gullo, Joseph 3959 N Buffalo Orchard Park NY 14127 Erie 7166628102

Hammer, Joann M. Audiology UB speech & Hearing Center Beb Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Hammer, Joann M. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Hammer, Joann M. Audiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hammer, Joann M. Audiology Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Hammer, Joann M. Audiology Buffalo Hearing & Speech 6941 Elaine Dr Buffalo NY 14204 Erie 7162367887

Hammer, Joann M. Audiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hammer, Joann M. Audiology Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Bldg Buffalo NY 14214 Erie 7168293980

Hammer, Joann M. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Harter, Georgia N. Audiology Village Audiology and Hearing Aid Services, PLLC 56 Church St Lancaster NY 14086 Erie 7166816722

Harter, James R. Audiology Village Audiology and Hearing Aid Services, PLLC 56 Church St Lancaster NY 14086 Erie 7166816722

Hartman, Danielle L. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858371

Hartman, Danielle L. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Hartman, Danielle L. Audiology Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Hill, Jeanne E. Audiology Aurora Audiology & Speech Assoc Inc 97 Hamburg St East Aurora NY 14052 Erie 7166526464

Jackson, Kristina M. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Jackson, Kristina M. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Jackson, Kristina M. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Jackson, Kristina M. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Jackson, Kristina M. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Jackson, Kristina M. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Joyce, Jerri K. Audiology Jennifer Schneider 630 Orchard Pk Rd West Seneca NY 14224 Erie 7167122000

Klatt, Barbara Audiology Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7168719915

Klatt, Barbara Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719915

Klatt, Barbara Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7168719915

Klatt, Barbara Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7168719915

Koch, Edward F. Audiology Buffalo Medical Group 295 Essjay Rd Buffalo NY 14221 Erie 7166301000

Koch, Edward F. Audiology Buffalo Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Koch, Edward F. Audiology Delaware Audiology Group PC 1083 Delaware Ave Ste 200 Buffalo NY 14209 Erie 7168866462

Koch, Edward F. Audiology Delaware Audiology Group PC 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Koch, Edward F. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Koch, Edward F. Audiology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Koch, Edward F. Audiology Delaware Audiology Group PC 295 Essjay Rd Buffalo NY 14221 Erie 7166301188

Krause, Susanne M. Audiology Ken-Ton Hearing PC 3306 Delaware Ave Kenmore NY 14217 Erie 7168741609

Kruger, Pamela T. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Kruger, Pamela T. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Kruger, Pamela T. Audiology Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Lavallee, Donna M. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Lavallee, Donna M. Audiology Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502045

Lavallee, Donna M. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Lavallee, Donna M. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Lavallee, Donna M. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Page 10 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lavallee, Donna M. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Lavallee, Donna M. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Leon, Sarah M. Audiology Amherst Audiological Services PC 315 Alberta Dr Ste 105 Amherst NY 14226 Erie 7168385360

Lichtenthal, Peggy A. Audiology Ken-Ton Hearing PC 3306 Delaware Ave Kenmore NY 14217 Erie 7168741609

Long, Jennifer E. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Long, Jennifer E. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Long, Jennifer E. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Long, Jennifer E. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Long, Jennifer E. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Long, Jennifer E. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Makey, Katrina Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Makey, Katrina Audiology Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Makey, Katrina Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Marczewski, Caitlin B. Audiology Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Marczewski, Caitlin B. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Marczewski, Caitlin B. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Martin McMahon, Karen Audiology Hearing Health Center 2113 Delaware Ave Ste B12 Buffalo NY 14216 Erie 7164471819

Martin McMahon, Karen Audiology Hearing Health Center 6970 Erie Rd Ste A Derby NY 14047 Erie 7169470185

Martin McMahon, Karen Audiology Hearing Health Center 7008 Erie Rd Ste A Derby NY 14047 Erie 7164398049

Martin McMahon, Karen Audiology Hearing Health Center 1275 Delaware Ave Ste B 12 Buffalo NY 14209 Erie 7168852410

McFarlane, Tracy A. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

McFarlane, Tracy A. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

McNerney, Kathleen M. Audiology Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Bldg Buffalo NY 14214 Erie 7168293980

McNerney, Kathleen M. Audiology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Messineo, Marc J. Audiology Messineo, Marc 3950 E Robinson Rd Ste 106 Amherst NY 14228 Erie 7166913817

Miller, Michelle L. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Minniefield, Angela M. Audiology Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Minniefield, Angela M. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Minniefield, Angela M. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858371

Nelson, David T. Audiology Audiology Service Associates, P.C. 1150 Youngs Rd Ste 209 Williamsville NY 14221 Erie 7166337210

Nelson, David T. Audiology Audiology Service Associates, P.C. 103 Niagara St Tonawanda NY 14150 Erie 7166925605

Oppee, Jessica J. Audiology Audiology Service Associates, P.C. 1150 Youngs Rd Ste 209 Williamsville NY 14221 Erie 7166337210

Oppee, Jessica J. Audiology Audiology Service Associates, P.C. 103 Niagara St Tonawanda NY 14150 Erie 7166337210

Orsene, Anne Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Orsene, Anne Audiology Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Orsene, Anne Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Orsene, Anne Audiology Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Orsene, Anne Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Orsene, Anne Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Orsene, Anne Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Orsene, Anne Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Paes, Averill M. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Pawlak, Lynn T. Audiology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Perlow, Steven Audiology Accura Audiology PLLC 531 Farber Lakes Dr Buffalo NY 14221 Erie 7166330721

Perlow, Steven Audiology Accura Audiology PLLC 6645 Main St Ste B Williamsville NY 14221 Erie 7166330721

Perlow, Steven Audiology Accura Audiology PLLC 2671 Harlem Rd Cheektowaga NY 14225 Erie 7168921744

Pleban, Christine E. Audiology Ken-Ton Hearing PC 3306 Delaware Ave Buffalo NY 14217 Erie 7168741609

Pucci, David A. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Pucci, David A. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Pucci, David A. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Pucci, David A. Audiology Hearing & Speech Center of WNY 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Pucci, David A. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Roberts, Susan T. Audiology Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomed Educ Bldg Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Ryan, Marie T. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858371

Ryan, Marie T. Audiology Paul R Young MD PLLC 4955 N Bailey Ave Ste 202 Amherst NY 14226 Erie 7168328500

Ryan, Marie T. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Ryan, Marie T. Audiology Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Rybarczyk, Susan Audiology Audiology Service Associates, P.C. 1150 Youngs Rd Ste 204 Williamsville NY 14221 Erie 7166337210

Sawka, Brian J. Audiology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301188

Sawka, Brian J. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301000

Sawka, Brian J. Audiology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Schneider Jr, Daniel C. Audiology Genesee Hearing Services 630 Orchard Pk Rd Buffalo NY 14224 Erie 7167122000

Schneider Jr, Daniel C. Audiology Genesee Hearing Services 61 Wehrle Dr Cheektowaga NY 14225 Erie 7168376213

Schneider, Jennifer H. Audiology Jennifer Schneider 630 Orchard Pk Rd Buffalo NY 14224 Erie 7167122000

Schultz, Christine T. Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 Transit Rd Elma NY 14059 Erie 7166680233

Schultz, Christine T. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd STE 400 Hamburg NY 14075 Erie 7166497801

Page 11 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Schultz, Christine T. Audiology Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Buffalo NY 14221 Erie 7163621552

Schultz, Christine T. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Elmwood Ave Kenmore NY 14217 Erie 7168719915

Smith, Gisela Audiology Accura Audiology PLLC 6645 Main St Ste B Williamsville NY 14221 Erie 7166330721

Smith, Gisela Audiology Accura Audiology PLLC 2671 Harlem Rd Cheektowaga NY 14225 Erie 7168921744

Stachura, Julie L. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 CAMP RD STE 400 Hamburg NY 14075 Erie 7166497801

Stachura, Julie L. Audiology Diversified Services for OT PT SLP and Audiology LLC 17 LIMESTONE DR STE 5 Williamsville NY 14221 Erie 7163621552

Stachura, Julie L. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Stachura, Julie L. Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 TRANSIT RD STE 112 Elma NY 14059 Erie 7166680233

Stecker, Nancy A. Audiology Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomed Educ Bldg Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Stewart, Leslie B. Audiology Aurora Audiology & Speech Assoc Inc 97 Hamburg St East Aurora NY 14052 Erie 7166526464

Stocking, Christina T. Audiology Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Bldg Buffalo NY 14214 Erie 7168293980

Stocking, Christina T. Audiology Stocking, Christina 52 Biomed Educ Bldg Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Sutton, Jennifer D. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Sutton, Jennifer D. Audiology Hearing Evaluation Services 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Sutton, Jennifer D. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Sutton, Jennifer D. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Sutton, Jennifer D. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Sutton, Jennifer D. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Sutton, Jennifer D. Audiology Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502045

Tillery, Kim L. Audiology Tillery, Kim 3306 Delaware Ave Kenmore NY 14217 Erie 7168776404

Utech, Rebecca L. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719883

Utech, Rebecca L. Audiology Audiology Service Associates, P.C. 103 Niagara St Tonawanda NY 14150 Erie 7166925605

Utech, Rebecca L. Audiology Audiology Service Associates, P.C. 1150 Youngs Rd Ste 209 Williamsville NY 14221 Erie 7166337210

Utech, Rebecca L. Audiology Diversified Services for OT PT SLP and Audiology LLC 4855 Camp Rd Hamburg NY 14075 Erie 7166597801

Utech, Rebecca L. Audiology Diversified Services for OT PT SLP and Audiology LLC 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7166680233

Vecchio, Mary L. Audiology Diversified Services for OT PT SLP and Audiology LLC 17 Limeston Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Vecchio, Mary L. Audiology Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Wantuck, Rebecca L. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Wantuck, Rebecca L. Audiology Hearing Evaluation Services 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334488

Wantuck, Rebecca L. Audiology Hearing Evaluation Services 4063 North Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7166620707

Wantuck, Rebecca L. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Amherst NY 14226 Erie 7168334488

Wantuck, Rebecca L. Audiology Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502000

Wantuck, Rebecca L. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Wantuck, Rebecca L. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Whitcomb, Carolyn A. Audiology Hearing Evaluation Services 4600 Main St Ste 201 Buffalo NY 14226 Erie 7168334488

Whitcomb, Carolyn A. Audiology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Whitcomb, Carolyn A. Audiology Hearing Evaluation Services 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166333344

Whitcomb, Carolyn A. Audiology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Whitcomb, Carolyn A. Audiology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Wilcox, Marc L. Audiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Wilcox, Marc L. Audiology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Wojnowski, Adam A. Audiology Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Wojnowski, Adam A. Audiology Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Wojnowski, Adam A. Audiology Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Petras, Melissa L. Blood Banking/Transfusion University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Petras, Melissa L. Blood Banking/Transfusion University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Petras, Melissa L. Blood Banking/Transfusion University at Buffalo Pathologists PC 115 Flint Rd Williamsville NY 14221 Erie 7166267200

Petras, Melissa L. Blood Banking/Transfusion University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Albrecht, Friedrich J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Albrecht, Friedrich J. Cardiovascular Disease Suburban Cardiology PC 831 Maple Rd Williamsville NY 14221 Erie 7165651978

Albrecht, Friedrich J. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Alfaro Franco, Carina M. Cardiovascular Disease Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597280

Alfaro Franco, Carina M. Cardiovascular Disease Kaleida Health 100 High St Ste B-612 Buffalo NY 14203 Erie 7168595600

Arani, Djavad T. Cardiovascular Disease Arani, Djavad 1150 Youngs Rd Ste 101 Williamsville NY 14221 Erie 7166360189

Avino, David Cardiovascular Disease Avino, David 6400 Powers Rd Orchard Park NY 14127 Erie 7166670001

Avino, David Cardiovascular Disease Avino, David 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672064

Avino, David Cardiovascular Disease Cardiac Imaging PC 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

Baldwa, Sunil Cardiovascular Disease VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Banas, Michael D. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Banas, Michael D. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Banas, Michael D. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Banifatemi, Reza Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Banifatemi, Reza Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Banifatemi, Reza Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Banifatemi, Reza Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Buffalo NY 14221 Erie 7166345100

Banifatemi, Reza Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Page 12 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Bannon, Patrick J. Cardiovascular Disease Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Basra, Manreet Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Basra, Manreet Cardiovascular Disease Kaleida Health 900 Hertel Ave Hertal Elmwood Internal Med Clinic Buffalo NY 14216 Erie 7168711571

Basra, Manreet Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Basra, Manreet Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Basra, Manreet Cardiovascular Disease Kaleida Health 100 High St Ste D 8 Buffalo NY 14203 Erie 7168597280

Basra, Manreet Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Beck, Hiroko Cardiovascular Disease Kaleida Health 100 High St Ste B-8 Buffalo NY 14203 Erie 7168597280

Beck, Hiroko Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7169619900

Beck, Hiroko Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Beck, Hiroko Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Beck, Hiroko Cardiovascular Disease Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Beck, Hiroko Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bhatia, Ashish Cardiovascular Disease Buffalo Electrophysiology LLC 100 High St Buffalo NY 14203 Erie 7168591400

Bhayana, Ranjan Cardiovascular Disease VascuFlo, Inc 2470 Walden Ave Ste 300 Cheektowaga NY 14225 Erie 7166812968

Bhayana, Ranjan Cardiovascular Disease Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578610

Bhayana, Ranjan Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301164

Bhayana, Ranjan Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168874600

Bhayana, Ranjan Cardiovascular Disease VascuFlo, Inc 2447 Sheridan Dr Tonawanda NY 14150 Erie 7166812968

Bhayana, Ranjan Cardiovascular Disease Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301484

Bhayana, Ranjan Cardiovascular Disease Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Streets Buffalo NY 14263 Erie 7168452300

Boersma, Ronald B. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Boersma, Ronald B. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Boersma, Ronald B. Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Pk Ste 100 Orchard Park NY 14127 Erie 7166776800

Cai, John J. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Calandra, Salvatore M. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Calandra, Salvatore M. Cardiovascular Disease Kenmore Mercy Hospital 825 Wehrle Dr Buffalo NY 14221 Erie 7164476100

Calandra, Salvatore M. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Calandra, Salvatore M. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Calandra, Salvatore M. Cardiovascular Disease Kenmore Physician Association 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Calandra, Salvatore M. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Canty Jr, John M. Cardiovascular Disease Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874491

Canty Jr, John M. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Canty Jr, John M. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Carlson Jr, David E. Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301082

Carlson Jr, David E. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Carlson Jr, David E. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Chan Lam, Patrick D. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Chan Lam, Patrick D. Cardiovascular Disease Kenmore Physician Association 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476671

Chan Lam, Patrick D. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Chan Lam, Patrick D. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Chan Lam, Patrick D. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Chan Lam, Patrick D. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Chan Lam, Patrick D. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Chan Lam, Patrick D. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Chaskes, Michael J. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Chaskes, Michael J. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Chaskes, Michael J. Cardiovascular Disease Southtowns Cardiology PC 960 Center Rd West Seneca NY 14224 Erie 7166748502

Chaskes, Michael J. Cardiovascular Disease Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Chaskes, Michael J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Chaskes, Michael J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Tremont St Williamsville NY 14221 Erie 7165683600

Chaudhry, Eram Cardiovascular Disease Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Chaudhry, Eram Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Chaudhry, Eram Cardiovascular Disease Cardiovascular Care Services PLLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Chaudhry, Eram Cardiovascular Disease Cardiovascular Care Services PLLC 100 High St Buffalo NY 14203 Erie 7168595600

Chaudhry, Eram Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621982

Chaudhry, Eram Cardiovascular Disease Medicor Associates Inc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Chugh, Dennis B. Cardiovascular Disease Northtowns Cardiology PLLC 5530 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7165803810

Chugh, Dennis B. Cardiovascular Disease Northtowns Cardiology PLLC 1026 Union Rd West Seneca NY 14224 Erie 7165803810

Cimato, Thomas Cardiovascular Disease Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7169619900

Cimato, Thomas Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Cimato, Thomas Cardiovascular Disease Cardiology Reading Panel LLC 875 Ellicott St CTRC Ste 7030 Buffalo NY 14203 Erie 7168595600

Cimato, Thomas Cardiovascular Disease Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874491

Cimato, Thomas Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7169619900

Cobler, Joanne L. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Cobler, Joanne L. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Page 13 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Cobler, Joanne L. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Conley, James G. Cardiovascular Disease Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Conley, James G. Cardiovascular Disease Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Conley, James G. Cardiovascular Disease Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Conley, James G. Cardiovascular Disease Cardiographic Associates 100 High St Buffalo NY 14203 Erie 7168592981

Conley, James G. Cardiovascular Disease Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Conley, James G. Cardiovascular Disease Conley, James 100 High St Buffalo NY 14203 Erie 7168592981

Conley, James G. Cardiovascular Disease Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Conti, David R. Cardiovascular Disease Kenmore Physician Association 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Conti, David R. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Conti, David R. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Conti, David R. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Conti, David R. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Copley, Donald P. Cardiovascular Disease Donald P Copley MD PC 760 Millersport Hwy Amherst NY 14226 Erie 7168741772

Copley, Donald P. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Corbelli, Richard J. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Corbelli, Richard J. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Curtis, Anne Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Curtis, Anne Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7168826544

Curtis, Anne Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Curtis, Anne Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

D Angelo, Michael E. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

D Angelo, Michael E. Cardiovascular Disease Avino, David 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

D Angelo, Michael E. Cardiovascular Disease Cardiac Imaging PC 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

D Angelo, Michael E. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

D Angelo, Michael E. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168874600

D Angelo, Michael E. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

D Angelo, Michael E. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

D Arcy, Brian J. Cardiovascular Disease D'Arcy, Brian J. 515 Abbott Rd Buffalo NY 14220 Erie 7168282068

D Arcy, Brian J. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dean, David C. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Dean, David C. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Dean, David C. Cardiovascular Disease David Dean MD 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Dean, David C. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Dean, David C. Cardiovascular Disease David Dean MD 65 Huxley Drive Buffalo NY 14226 Erie 7068393085

Dean, David C. Cardiovascular Disease David Dean MD 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Dotsenko, Olena Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Emerson, Ronald P. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fallavollita, James A. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Fallavollita, James A. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Fallavollita, James A. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Fallavollita, James A. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Fallavollita, James A. Cardiovascular Disease Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168774491

Fallavollita, James A. Cardiovascular Disease VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 5186266985

Farhi, Eli R. Cardiovascular Disease Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578611

Farhi, Eli R. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Farhi, Eli R. Cardiovascular Disease Cardiographic Associates 85 High St Buffalo NY 14203 Erie 7168578611

Fernandez, Stanley F. Cardiovascular Disease Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874491

Fernandez, Stanley F. Cardiovascular Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Fernandez, Stanley F. Cardiovascular Disease Kaleida Health 900 Hertel Ave N Buffalo Medical Pk Buffalo NY 14216 Erie 7168812170

Fernandez, Stanley F. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Fernandez, Stanley F. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Fernandez, Stanley F. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168597277

Fernandez, Stanley F. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168597277

Fernandez, Stanley F. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Ford Mukkamala, Laura L. Cardiovascular Disease Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166564825

Ford Mukkamala, Laura L. Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564825

Ford Mukkamala, Laura L. Cardiovascular Disease Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166564825

Forte, Kenton E. Cardiovascular Disease Sheehan Memorial Hospital 305 Perry St Buffalo NY 14203 Erie 7168482000

Forte, Kenton E. Cardiovascular Disease Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482180

Forte, Kenton E. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Forte, Kenton E. Cardiovascular Disease Forte, Kenton 964 Delaware Ave Buffalo NY 14209 Erie 7168864202

Forte, Kenton E. Cardiovascular Disease Forte, Kenton 425 Michigan Ave Buffalo NY 14203 Erie 7168482420

Forte, Kenton E. Cardiovascular Disease Forte, Kenton 462 Grider St Buffalo NY 14240 Erie 7168983000

Gatewood Jr, Robert P. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Gatewood Jr, Robert P. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Page 14 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Gatewood Jr, Robert P. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Gatewood Jr, Robert P. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Gayles, Kenneth L. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Gayles, Kenneth L. Cardiovascular Disease Kenneth Gayles MDPC 840 Humboldt Pkwy Buffalo NY 14211 Erie 7168951100

Gelormini, Joseph L. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Gelormini, Joseph L. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Gelormini, Joseph L. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Gelormini, Joseph L. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Gelormini, Joseph L. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Gelormini, Joseph L. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Gianfagna, Robert A. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Gianfagna, Robert A. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Gianfagna, Robert A. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Gianfagna, Robert A. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Gianfagna, Robert A. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Glover, Robert F. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Glover, Robert F. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7169619900

Glover, Robert F. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Glover, Robert F. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Glover, Robert F. Cardiovascular Disease Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Glover, Robert F. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Glover, Robert F. Cardiovascular Disease Kenmore Physician Association 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Glover, Robert F. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Glover, Robert F. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gokhale, Rohit A. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Gokhale, Rohit A. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Gokhale, Rohit A. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Gokhale, Rohit A. Cardiovascular Disease Kaleida Health 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Gokhale, Rohit A. Cardiovascular Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Graham, Susan P. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592573

Graham, Susan P. Cardiovascular Disease Cardiology Reading Panel LLC 405 N French Rd Ste 104 Buffalo NY 14228 Erie 7166891901

Graham, Susan P. Cardiovascular Disease Kaleida Health 100 High St Cardiac Specialty Clinic B8 Buffalo NY 14203 Erie 7168591168

Gunawardane, Cyril Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Gunawardane, Cyril Cardiovascular Disease Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Gunawardane, Cyril Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Gunawardane, Cyril Cardiovascular Disease General Physician PC 100 High St Buffalo NY 14203 Erie 7168595600

Gunawardane, Cyril Cardiovascular Disease General Physician PC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Gutierrez, Matthew J. Cardiovascular Disease Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Haq, Nadeem U. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Haq, Nadeem U. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Haq, Nadeem U. Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Dr Ste 100 Orchard Park NY 14127 Erie 7166776800

Herle, Aravind Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Herle, Aravind Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Pk Ste 100 Orchard Park NY 14127 Erie 7166776800

Herle, Aravind Cardiovascular Disease Cardiology Group Of Western New York Pc 7060 Erie Rd Ste 100 Derby NY 14047 Erie 7169474851

Herle, Aravind Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hong, Michael J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Hong, Michael J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Hong, Michael J. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Hong, Michael J. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hong, Michael J. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Horn, Steven J. Cardiovascular Disease Southtowns Cardiology PC 960 Center Rd West Seneca NY 14224 Erie 7166748502

Horn, Steven J. Cardiovascular Disease Cardiology Reading Panel LLC 445 Tremont St Buffalo NY 14210 Erie 7166944500

Horn, Steven J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Horn, Steven J. Cardiovascular Disease Northtowns Cardiology PLLC 1026 Union Rd West Seneca NY 14224 Erie 7165803810

Horn, Steven J. Cardiovascular Disease Cardiology Reading Panel LLC 222-2224 E Main St Springville NY 14141 Erie 7165922871

Horn, Steven J. Cardiovascular Disease Clarence Cardiology LLC 9095 Main St Ste D Clarence NY 14031 Erie 7166748502

Horn, Steven J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Horn, Steven J. Cardiovascular Disease Northtowns Cardiology PLLC 5530 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7165803810

Iacona, Marie A. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Iacona, Marie A. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Iacona, Marie A. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Iacona, Marie A. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Iacona, Marie A. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Iacona, Marie A. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Iyer, Vijay S. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Iyer, Vijay S. Cardiovascular Disease Kaleida Health 100 High St Ste D 8 Buffalo NY 14203 Erie 7168597280

Page 15 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Iyer, Vijay S. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Iyer, Vijay S. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Iyer, Vijay S. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168597277

Iyer, Vijay S. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Jennings, Richard A. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14227 Erie 7168223098

Jennings, Richard A. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Jennings, Richard A. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Jennings, Richard A. Cardiovascular Disease Buffalo Heart Group LCP 3780 Commerce Ct Ste 100 Tonawanda NY 14150 Erie 7168352966

Jennings, Richard A. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Jennings, Richard A. Cardiovascular Disease Buffalo Heart Group LCP 4855 Camp Rd Hamburg NY 14075 Erie 7168223098

Jennings, Richard A. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Jennings, Richard A. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14224 Erie 7168267000

Joy Pardi, Judyann V. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Joy Pardi, Judyann V. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Joy Pardi, Judyann V. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Joy Pardi, Judyann V. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Joy Pardi, Judyann V. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Joy Pardi, Judyann V. Cardiovascular Disease Suburban Cardiology PC 831 Maple Rd Williamsville NY 14221 Erie 7165651978

Karkut, Christopher J. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Karkut, Christopher J. Cardiovascular Disease Bruce L Platt MD PC 1616 Kensington Ave Buffalo NY 14215 Erie 7168343278

Khalil Ibrahim, Mofid N. Cardiovascular Disease Southtowns Cardiology PC 960 Center Rd West Seneca NY 14224 Erie 7166748502

Khalil Ibrahim, Mofid N. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Khalil Ibrahim, Mofid N. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Khalil Ibrahim, Mofid N. Cardiovascular Disease Cardiology Reading Panel LLC 445 Tremont St Buffalo NY 14210 Erie 7166944500

Khalil Ibrahim, Mofid N. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Khalil Ibrahim, Mofid N. Cardiovascular Disease Clarence Cardiology LLC 9095 Main St Clarence NY 14031 Erie 7166310092

Khan, Irfan Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Khan, Irfan Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Khan, Irfan Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352983

Khan, Irfan Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Khan, Irfan Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kozinn, Marc J. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Kozinn, Marc J. Cardiovascular Disease Kozinn, Marc 8604 Main St Ste 4 Williamsville NY 14221 Erie 7166357600

Kozinn, Marc J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Kozinn, Marc J. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Kozlowski, Lisa C. Cardiovascular Disease Cardiology Reading Panel LLC 6460 Main Street Williamsville NY 14221 Erie 7166345100

Kozlowski, Lisa C. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Kozlowski, Lisa C. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Kozlowski, Lisa C. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Kozlowski, Lisa C. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Kozlowski, Lisa C. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Krawczyk, Justine A. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Krawczyk, Justine A. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Krawczyk, Justine A. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Krawczyk, Justine A. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Krawczyk, Justine A. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Krawczyk, Justine A. Cardiovascular Disease St Joseph Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7168912423

Krawczyk, Justine A. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Luisi Jr, Andrew J. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Luisi Jr, Andrew J. Cardiovascular Disease Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301288

Luisi Jr, Andrew J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Luisi Jr, Andrew J. Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301288

Luisi Jr, Andrew J. Cardiovascular Disease Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301288

Maddi, Joseph L. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Maddi, Joseph L. Cardiovascular Disease Joseph L Maddi Physician PC 4225 Maple Rd Buffalo NY 14226 Erie 7168340221

Maddi, Joseph L. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Maddi, Joseph L. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168332073

Madhusudanan, Mohan Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Madhusudanan, Mohan Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Madhusudanan, Mohan Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14227 Erie 7168223098

Madhusudanan, Mohan Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Madhusudanan, Mohan Cardiovascular Disease Buffalo Heart Group LCP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Madhusudanan, Mohan Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Malhotra, Saurabh Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Malhotra, Saurabh Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Malhotra, Saurabh Cardiovascular Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Page 16 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Malhotra, Saurabh Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Masud, A R Zaki Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Masud, A R Zaki Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Masud, A R Zaki Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Masud, A R Zaki Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168874600

Masud, A R Zaki Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Matthews, George E. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Matthews, George E. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Matthews, George E. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Matthews, George E. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Matthews, George E. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

McClure, Matthew G. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

McClure, Matthew G. Cardiovascular Disease Cardiology Group Of Western New York Pc 7060 Erie Rd Ste 100 Derby NY 14047 Erie 7169474851

McClure, Matthew G. Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Pk Ste 100 Orchard Park NY 14127 Erie 7166776800

McClure, Matthew G. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

McCrea III, Harry E. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14224 Erie 7168267000

McCrea III, Harry E. Cardiovascular Disease Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013745

McCrea III, Harry E. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

McCrea III, Harry E. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

McCrea III, Harry E. Cardiovascular Disease Kenmore Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013745

McCrea III, Harry E. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Meesala, Mrinalini Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Dr Ste 100 Orchard Park NY 14127 Erie 7166776800

Meesala, Mrinalini Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Meesala, Mrinalini Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Meesala, Mrinalini Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Meesala, Mrinalini Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Meesala, Mrinalini Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Meesala, Mrinalini Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Meholick, Alan W. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Meholick, Alan W. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Meholick, Alan W. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Meholick, Alan W. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Meholick, Alan W. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Meholick, Alan W. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Meholick, Alan W. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Mehta, Vinay Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14225 Erie 7168223098

Mehta, Vinay Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Mehta, Vinay Cardiovascular Disease Buffalo Heart Group LCP 4855 Camp Rd Hamburg NY 14075 Erie 7168223098

Mehta, Vinay Cardiovascular Disease Buffalo Heart Group LCP 3780 Commerce Ct Ste 100 Tonawanda NY 14150 Erie 7168352966

Mehta, Vinay Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166013690

Mehta, Vinay Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Mehta, Vinay Cardiovascular Disease Buffalo Heart Group LCP 1829 Maple Rd Williamsville NY 14221 Erie 7166346879

Mehta, Vinay Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Mehta, Vinay Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166013690

Mehta, Vinay Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7166013690

Meltser, Henry M. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Buffalo NY 14221 Erie 7166343243

Meltser, Henry M. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Meltser, Henry M. Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Ave Ste 100 Orchard Park NY 14127 Erie 7166776800

Merhige, Michael E. Cardiovascular Disease Merhige, Michael 6460 Main St Williamsville NY 14221 Erie 7168351545

Merhige, Michael E. Cardiovascular Disease Merhige, Michael 2447 Sheridan Dr Tonawanda NY 14150 Erie 7168351545

Morris, William M. Cardiovascular Disease Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578659

Morris, William M. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Morris, William M. Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7168578659

Morris, William M. Cardiovascular Disease Kaleida Health 100 High St B 8 BGH Cardiac Specialty Clinic Buffalo NY 14203 Erie 7168597280

Neufeld, Robert J. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Neufeld, Robert J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Neufeld, Robert J. Cardiovascular Disease Neufeld, Robert 1801 Grand Island Blvd Grand Island NY 14072 Erie 7162845682

Neufeld, Robert J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Ocampos, Deolindo Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Ave Ste 100 Orchard Park NY 14127 Erie 7166776800

Ocampos, Deolindo Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Orlick, Arthur E. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Orlick, Arthur E. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Orlick, Arthur E. Cardiovascular Disease VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7168983000

Ozcan, Cevher Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Ozcan, Cevher Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ozcan, Cevher Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page 17 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Ozcan, Cevher Cardiovascular Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 5186232844

Page, Brian J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page, Brian J. Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Page, Brian J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Page, Brian J. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592573

Petrella, Richard W. Cardiovascular Disease Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Phadke, Kishor V. Cardiovascular Disease Northtowns Cardiology PLLC 1026 Union Rd West Seneca NY 14224 Erie 7165803810

Phadke, Kishor V. Cardiovascular Disease Northtowns Cardiology PLLC 5530 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7165803810

Platt, Bruce L. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168332073

Platt, Bruce L. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Platt, Bruce L. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Platt, Bruce L. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Platt, Bruce L. Cardiovascular Disease Bruce L Platt MD PC 1616 Kensington Ave Buffalo NY 14215 Erie 7168343278

Platt, Bruce L. Cardiovascular Disease Bruce L Platt MD PC 12845 Broadway Alden NY 14004 Erie 7169373503

Platt, Bruce L. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Raabe, John Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Raabe, John Cardiovascular Disease Cardiology Group Of Western New York Pc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Raabe, John Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Raabe, John Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Raabe, John Cardiovascular Disease Cardiology Group Of Western New York Pc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Raabe, John Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Dr Ste 100 Orchard Park NY 14127 Erie 7166776800

Rana, Muzamil I. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Rana, Muzamil I. Cardiovascular Disease Northtowns Cardiology PLLC 1026 Union Rd West Seneca NY 14224 Erie 7165803810

Rana, Muzamil I. Cardiovascular Disease Northtowns Cardiology PLLC 5530 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7165803810

Riegel, Brian J. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Riegel, Brian J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Riegel, Brian J. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Riegel, Brian J. Cardiovascular Disease Cardiac Imaging PC 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

Riegel, Brian J. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Riegel, Brian J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168874600

Roberts, Douglas L. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Roberts, Douglas L. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Roberts, Douglas L. Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Pk Ste 100 Orchard Park NY 14127 Erie 7166776800

Rozmus, Grzegorz P. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Rozmus, Grzegorz P. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Rueda, Benjamin G. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Rueda, Benjamin G. Cardiovascular Disease WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Rueda, Benjamin G. Cardiovascular Disease Kenmore Physician Association 50 Alcona Ave Buffalo NY 14226 Erie 7168341191

Rycyna, James L. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Rycyna, James L. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Rycyna, James L. Cardiovascular Disease Health Monitoring Svcs Of Amer Inc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Rycyna, James L. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Rycyna, James L. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Rycyna, James L. Cardiovascular Disease Kenmore Physician Association 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Rycyna, James L. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Sachar, Rajinder S. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Sachar, Rajinder S. Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Sachar, Rajinder S. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Sachar, Rajinder S. Cardiovascular Disease Sachar, Rajinder S. 2848 William St Cheektowaga NY 14227 Erie 7168930900

Saito, Yuji Cardiovascular Disease Bruce L Platt MD PC 1616 Kensington Ave Buffalo NY 14215 Erie 7168343278

Saito, Yuji Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621759

Saito, Yuji Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Saito, Yuji Cardiovascular Disease Cardiographic Associates 2605 Harlem Rd Buffalo NY 14225 Erie 7168912420

Shah, Syed A. Cardiovascular Disease Bertrand Chaffee Hospital 222 224 E Main St Springville NY 141411443 Erie 7165928140

Shah, Syed A. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168283724

Sharma, Umesh Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Sharma, Umesh Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Sharma, Umesh Cardiovascular Disease Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Sharma, Umesh Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Sharma, Umesh Cardiovascular Disease Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597280

Smith Jr, Thomas P. Cardiovascular Disease Southtowns Cardiology PC 1026 Union Rd Buffalo NY 14224 Erie 7166748502

Smith Jr, Thomas P. Cardiovascular Disease Southtowns Cardiology PC 960 Center Rd Buffalo NY 14224 Erie 7166748502

Smith Jr, Thomas P. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Smith Jr, Thomas P. Cardiovascular Disease Bertrand Chaffee Hospital 222 224 E Main St Springville NY 14141 Erie 7165928140

Sobieraj, Scott R. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Sobieraj, Scott R. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Page 18 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Sobieraj, Scott R. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Sobieraj, Scott R. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Spangenthal, Edward J. Cardiovascular Disease Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Spangenthal, Edward J. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Spangenthal, Edward J. Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301156

Spangenthal, Edward J. Cardiovascular Disease Cardiology Reading Panel LLC 3 Gates Cir Buffalo NY 14209 Erie 7168874180

Spangenthal, Edward J. Cardiovascular Disease Cardiology Reading Panel LLC 6333 Main St Williamsville NY 14221 Erie 7166301484

Spangenthal, Edward J. Cardiovascular Disease Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301484

Spangenthal, Edward J. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Stern, Gary R. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Stern, Gary R. Cardiovascular Disease Cardiology Group Of Western New York Pc 310 Sterling Pk Ste 100 Orchard Park NY 14127 Erie 7166776800

Strasser, David M. Cardiovascular Disease Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Sullivan, Philip R. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Sullivan, Philip R. Cardiovascular Disease Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Sullivan, Philip R. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Sullivan, Philip R. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Sullivan, Philip R. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Switzer, Donald F. Cardiovascular Disease TCD Medical Testing PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7162502002

Switzer, Donald F. Cardiovascular Disease Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301484

Switzer, Donald F. Cardiovascular Disease Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301484

Syed, Arif S. Cardiovascular Disease Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Visco, John P. Cardiovascular Disease Cardiographic Associates 210 E Main St Springville NY 14141 Erie 7165923600

Visco, John P. Cardiovascular Disease General Physician PC 210 E Main St Springville NY 14141 Erie 7165923600

Visco, John P. Cardiovascular Disease Visco, John 100 High St Buffalo NY 14203 Erie 7168592748

Visco, John P. Cardiovascular Disease Diagnostic X-Ray Service Inc 224 E Main St Springville NY 14141 Erie 7165922871

Visco, John P. Cardiovascular Disease Diagnostic X-Ray Service Inc 6000 N Bailey Ave Ste 1C Amherst NY 14226 Erie 7166346633

Visco, John P. Cardiovascular Disease Cardiographic Associates 100 High St Buffalo NY 14203 Erie 7168592748

Wadhawan, Sachin Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Wadhawan, Sachin Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352981

Wadhawan, Sachin Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Wadhwani, Jai G. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Wadhwani, Jai G. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Wadhwani, Jai G. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Wadhwani, Jai G. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus Frontier Heart Assoc Pc 462 Grider St Buffalo NY 14215 Erie 7168941255

Wadhwani, Jai G. Cardiovascular Disease Wadhwani, Jai 6388 Cloverleaf Cir East Amherst NY 14051 Erie 7164004646

Wadhwani, Jai G. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Wall, Robbie D. Cardiovascular Disease Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013745

Wall, Robbie D. Cardiovascular Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14224 Erie 7168267000

Wall, Robbie D. Cardiovascular Disease Cardiology Group Of Western New York Pc 825 Wehrle Dr Williamsville NY 14221 Erie 7166343243

Wall, Robbie D. Cardiovascular Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Wilson, Michael F. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Wilson, Michael F. Cardiovascular Disease Wilson, Michael 3 Gates Cir Buffalo NY 14209 Erie 7168874093

Wilson, Michael F. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Wilson, Michael F. Cardiovascular Disease Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874021

Wilson, Michael F. Cardiovascular Disease University Neuclear Med Dept 97 3980 Sheridan Dr Ste 100 Amherst NY 14226 Erie 7168348194

Wilson, Michael F. Cardiovascular Disease Clarence Cardiology LLC 9095 Main St Clarence NY 14031 Erie 7168874093

Young, Herbert G. Cardiovascular Disease Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Zizzi Jr, Joseph A. Cardiovascular Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Zizzi Jr, Joseph A. Cardiovascular Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Zizzi Jr, Joseph A. Cardiovascular Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168332073

Zlotnick, David M. Cardiovascular Disease Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Zlotnick, David M. Cardiovascular Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Zlotnick, David M. Cardiovascular Disease Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Zlotnick, David M. Cardiovascular Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Bierbrauer, Mary D. Certified Diabetic Educator Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Byrd, Emma W. Certified Diabetic Educator UB Family Medicine Inc 1315 Jefferson Ave Buffalo NY 14208 Erie 7163323797

Byrd, Emma W. Certified Diabetic Educator UB Family Medicine Inc 850 Hopkins Rd Williamsville NY 14221 Erie 7166889641

Caruana, Mildred M. Certified Diabetic Educator Amherst Medical Associates LLP 6000 N Bailey Ave Ste 1D Amherst NY 14226 Erie 7168344266

Fronczek, Dawn E. Certified Diabetic Educator Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Howard, Elizabeth P. Certified Diabetic Educator Eizabeth P Howard 226 Winston Rd Buffalo NY 14216 Erie 7168381694

Sorci, Joanne H. Certified Diabetic Educator Joanne H Sorci 86 Rue Madeleine Williamsville NY 14221 Erie 7166265170

Burch, Erin M. Certified Dietician/Nutrit Erin Burch Nutrition PLLC 164 Crofton Dr West Seneca NY 14224 Erie 7164985863

Cardamone, Kelly M. Certified Dietician/Nutrit Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168884556

Cardamone, Kelly M. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7165232398

Cardamone, Kelly M. Certified Dietician/Nutrit Elizabeth Pierce Olmsted MD Center for the Visually Imp 1170 Main St Buffalo NY 14209 Erie 7168821025

Cino, Shannon P. Certified Dietician/Nutrit Jennifer Erickson DO & Robert Erickson D 3671 Southwestern Blvd Ste 213 Orchard Park NY 14127 Erie 7166627008

Page 19 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Cino, Shannon P. Certified Dietician/Nutrit Norma Quijada Md 200 Sterling Dr Ste 400 Orchard Park NY 14127 Erie 7166770250

Clark, Nicole M. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Copperthite, Dawn Certified Dietician/Nutrit Christian Counseling Ministries of WNY 9070 Main St Clarence NY 14031 Erie 7162288163

Ensminger, Jeffrey C. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Ensminger, Jeffrey C. Certified Dietician/Nutrit Mobile Primary Care Family Nurse Practitioners PLLC 640 Ellicott St Ste 105 Buffalo NY 14203 Erie 7168931010

Flavin, Sheila M. Certified Dietician/Nutrit Flavin, Sheila M. 2430 N Forest Rd Ste 140 Getzville NY 14068 Erie 7164722955

Gentile, Karen L. Certified Dietician/Nutrit Propel Health 1012 A Union Rd West Seneca NY 14224 Erie 7166741148

Gentile, Karen L. Certified Dietician/Nutrit VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Giardina, Francesco Certified Dietician/Nutrit Frank Giardina 42 Hamilton Dr Amherst NY 14226 Erie 7162202342

Giardina, Francesco Certified Dietician/Nutrit Frank Giardina 5500 Main St Ste 7B Williamsville NY 14221 Erie 7162202342

Giardina, Francesco Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Kamm, Shannon L. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Kazinski, Evelyn A. Certified Dietician/Nutrit Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168884556

Kazinski, Evelyn A. Certified Dietician/Nutrit Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Kessel, Amanada L. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Klein, Ann S. Certified Dietician/Nutrit Medical Associates Southtown PC 300 Center Rd West Seneca NY 14224 Erie 7166753754

Kovalick, Jennifer L. Certified Dietician/Nutrit Jennifer L Kovalick 6680 Main St Williamsville NY 14221 Erie 7169129103

Lowman, Christina M. Certified Dietician/Nutrit Christina Lowman 229 Lake St Hamburg NY 14075 Erie 7164320729

McNess, Rachel C. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Mihalko, Kerry L. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Nickerson, Moreen N. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Odachowski, Allyson E. Certified Dietician/Nutrit Odachowski, Allyson E. 4578 S Ayers Rd Akron NY 14001 Erie 7165531554

Pacella, Danielle N. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Peckham, Natalie J. Certified Dietician/Nutrit Peckham, Natalie J. 366 Linden Ave Buffalo NY 14216 Erie 7162475051

Possinger, Candi S. Certified Dietician/Nutrit Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168884556

Possinger, Candi S. Certified Dietician/Nutrit Christine Conley Reeb 3685 Southwestern Blvd Orchard Park NY 14127 Erie 7166622408

Reeb, Christine C. Certified Dietician/Nutrit Christine Conley Reeb 3685 Southwestern Blvd Orchard Park NY 14127 Erie 7166622408

Sauer, Tricia E. Certified Dietician/Nutrit Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301129

Sauer, Tricia E. Certified Dietician/Nutrit Buffalo Medical Group 2741 Transit Rd Elma NY 14059 Erie 7166776060

Sauer, Tricia E. Certified Dietician/Nutrit Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301129

Seaman Knoerzer, June R. Certified Dietician/Nutrit J R Seaman-Knoerzer 4125 Transit Rd Williamsville NY 14221 Erie 7163162444

Seaman Knoerzer, June R. Certified Dietician/Nutrit Gastroenterology Associates LLP 60 Maple Rd Ste 1 Williamsville NY 14221 Erie 7166265250

Seaman Knoerzer, June R. Certified Dietician/Nutrit J R Seaman-Knoerzer 390 Harris Hill Rd Williamsville NY 14221 Erie 7163162444

Shamaa, Rawan R. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Simson, Rachel Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Smith, Jessica L. Certified Dietician/Nutrit Jessica Lee Smith 6498 Stevens Rd Hamburg NY 14075 Erie 7168800197

Thompson Dipaolo, Sarah Certified Dietician/Nutrit Thompson Dipaolo, Sarah A. 12835 Whitney Rd Holland NY 14080 Erie 7163163722

Tubin, Stefanie B. Certified Dietician/Nutrit Blue Circle Dietetics & Nutrition PC 574 Main St Ste 203 East Aurora NY 14052 Erie 7166083110

Tubin, Stefanie B. Certified Dietician/Nutrit Stefanie Blake Tubin 9070 Michael Douglas Dr Clarence Center NY 14032 Erie 7163081552

Yoder, Melinda C. Certified Dietician/Nutrit Melinda Bewley, RD 350 Alberta Dr Ste 109 Amherst NY 14226 Erie 7165537826

Clutterbuck, Elaine Certified Nurse Midwife Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168283520

Clutterbuck, Elaine Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Clutterbuck, Elaine Certified Nurse Midwife Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168588422

Clutterbuck, Elaine Certified Nurse Midwife Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Covel, Christine B. Certified Nurse Midwife Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Farnham, Tammy L. Certified Nurse Midwife Nurse Midwife Group Of U Of R 8750 Transit Rd Ste 205 East Amherst NY 14051 Erie 7166397970

Farnham, Tammy L. Certified Nurse Midwife Amherst Ob/Gyn Associates PC 8750 Transit Rd Ste 205 East Amherst NY 14051 Erie 7166397970

Field, Jennifer B. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282568

Field, Jennifer B. Certified Nurse Midwife Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168283510

Field, Jennifer B. Certified Nurse Midwife Mercy Hospital 565 Abbott Road Buffalo NY 14220 Erie 7168267000

Field, Jennifer B. Certified Nurse Midwife Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168283510

Field, Jennifer B. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Guay, Jennifer M. Certified Nurse Midwife Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165683753

Heldwein, Margaret M. Certified Nurse Midwife Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Heldwein, Margaret M. Certified Nurse Midwife Sisters of Charity Hospital : St Joseph Campus 288 Linwood Ave Buffalo NY 14209 Erie 7168854401

Hernandez, Evette M. Certified Nurse Midwife Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Hernandez, Evette M. Certified Nurse Midwife Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Hernandez, Evette M. Certified Nurse Midwife Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Hernandez, Evette M. Certified Nurse Midwife Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Lillis, Linda R. Certified Nurse Midwife Mercy Hospital 565 Abbott Road Buffalo NY 14220 Erie 7168267000

Lillis, Linda R. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282568

Lillis, Linda R. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282568

Lillis, Linda R. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lombardo, Amy B. Certified Nurse Midwife Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7166923302

Lombardo, Amy B. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Mecca, Kimberly C. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Page 20 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Mecca, Kimberly C. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Mecca, Kimberly C. Certified Nurse Midwife OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Mecca, Kimberly C. Certified Nurse Midwife OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Mecca, Kimberly C. Certified Nurse Midwife James Pilc MD FACOG PC 8604 Main St Ste 4 Buffalo NY 14221 Erie 7168100971

Nisengard, Sharon H. Certified Nurse Midwife Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168283510

Nisengard, Sharon H. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282895

Nisengard, Sharon H. Certified Nurse Midwife Mercy Hospital 565 Abbot Rd Buffalo NY 14220 Erie 7168267000

Pace, Sheila M. Certified Nurse Midwife Delta OB-GYN, PLLC 224 E Main St Springville NY 14141 Erie 7165928151

Pace, Sheila M. Certified Nurse Midwife General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Pace, Sheila M. Certified Nurse Midwife Delta OB-GYN, PLLC 1026 Union Rd West Seneca NY 14224 Erie 7167120862

Pace, Sheila M. Certified Nurse Midwife General Physician PC 1185 Sweet Home Rd Buffalo NY 14226 Erie 7162130025

Pace, Sheila M. Certified Nurse Midwife General Physician PC 1275 Delaware Ave Buffalo NY 14209 Erie 7168822424

Pace, Sheila M. Certified Nurse Midwife General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Pace, Sheila M. Certified Nurse Midwife General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Pace, Sheila M. Certified Nurse Midwife General Physician PC 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166564077

Pace, Sheila M. Certified Nurse Midwife General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Price, Katherine E. Certified Nurse Midwife Kaleida Health 1540 Maple Rd Williamsville NY 142213647 Erie 7165683600

Riester, Heather C. Certified Nurse Midwife Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Riester, Heather C. Certified Nurse Midwife Amherst Ob/Gyn Associates PC 8750 Transit Rd Ste 205 East Amherst NY 14051 Erie 7166397970

Sabatino, Kristine M. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Sabatino, Kristine M. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Sabatino, Kristine M. Certified Nurse Midwife Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168283510

Sabatino, Kristine M. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14227 Erie 7168282600

Sabatino, Kristine M. Certified Nurse Midwife Mercy Hospital 27 Franklin St Ste 1 Springville NY 14141 Erie 7165927400

Schaefer Turner, Margaret M. Certified Nurse Midwife Western New York Ob Gyn Pc 755 Wehrle Dr Cheektowaga NY 14225 Erie 7166340600

Schaefer Turner, Margaret M. Certified Nurse Midwife Moeen Abu-Sitta MD PC 755 Wehrle Dr Buffalo NY 14225 Erie 7166340600

Sexton, Katharyn F. Certified Nurse Midwife Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Stack, Catherine C. Certified Nurse Midwife Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7166923302

Vargo, Kelly L. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168277000

Vargo, Kelly L. Certified Nurse Midwife Santos, Carlos 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Vargo, Kelly L. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7166013745

Vargo, Kelly L. Certified Nurse Midwife Diane M Sanfilippo MD 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Vargo, Kelly L. Certified Nurse Midwife OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Vargo, Kelly L. Certified Nurse Midwife OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Weislo, Martha A. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Worrell, Sarah G. Certified Nurse Midwife Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Worrell, Sarah G. Certified Nurse Midwife Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168282775

Worrell, Sarah G. Certified Nurse Midwife Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Zitzka, Wendy E. Certified Nurse Midwife Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Zitzka, Wendy E. Certified Nurse Midwife Delta OB-GYN, PLLC 1026 Union Rd West Seneca NY 14224 Erie 7167120862

Zitzka, Wendy E. Certified Nurse Midwife Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Zitzka, Wendy E. Certified Nurse Midwife Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Adragna, Michael S. Child & Adolescent Neurology Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Adragna, Michael S. Child & Adolescent Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168351246

Adragna, Michael S. Child & Adolescent Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168351246

Adragna, Michael S. Child & Adolescent Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Adragna, Michael S. Child & Adolescent Psychiatry University Psychiatric Practice Inc 1028 Main St Buffalo NY 14222 Erie 7168595454

Chruscicki, Joseph E. Child & Adolescent Psychiatry Suburban Psychiatric Assoc 85 Bryants Woods S Amherst NY 14228 Erie 7166893333

Cooke, Ronald A. Child & Adolescent Psychiatry Niagara Falls Memorial Medical Center 3350 Main St Buffalo NY 14214 Erie 7168354011

Cooke, Ronald A. Child & Adolescent Psychiatry Niagara Falls Memorial Medical Center 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Cooke, Ronald A. Child & Adolescent Psychiatry Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Denny, Kevin M. Child & Adolescent Psychiatry HEART Community Alliance 1131 Kensington Ave Buffalo NY 14215 Erie 7168340080

Elberg, Zhanna Child & Adolescent Psychiatry University Psychiatric Practice Inc 462 Grider St Ste 1168 Buffalo NY 14215 Erie 7168984857

Elberg, Zhanna Child & Adolescent Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Ste 130 Amherst NY 14226 Erie 7168351246

Kaye, David L. Child & Adolescent Psychiatry University Psychiatric Practice Inc 3 Gates Cir 8th Flr Buffalo NY 14209 Erie 7168875800

Kaye, David L. Child & Adolescent Psychiatry Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168875800

Kaye, David L. Child & Adolescent Psychiatry University Psychiatric Practice Inc 1028 Main St Buffalo NY 14202 Erie 7168595454

Martin, Christopher G. Child & Adolescent Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Meer, Shahnawaz Child & Adolescent Psychiatry Jamestown Psychiatric PC 7020 Erie Rd Derby NY 14047 Erie 7165264041

Meer, Shahnawaz Child & Adolescent Psychiatry Jamestown Psychiatric PC 2625 Harlem Rd Stee 160 Buffalo NY 14225 Erie 7164832603

Miller, Bruce D. Child & Adolescent Psychiatry Kaleida Health 219 Bryant St 8th Fl Buffalo NY 14222 Erie 7168875800

Miller, Bruce D. Child & Adolescent Psychiatry University Psychiatric Practice Inc 219 Bryant St Buffalo NY 14222 Erie 7168875800

Schaeffer, Rebecca L. Child & Adolescent Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984857

Sengupta, Sourav Child & Adolescent Psychiatry CHC of Buffalo INC 34 Benwood Ave Buffalo NY 14214 Erie 7169869199

Sengupta, Sourav Child & Adolescent Psychiatry University Psychiatric Practice Inc 4955 N Bailey ave Ste 130 Amherst NY 14226 Erie 7168351246

Sengupta, Sourav Child & Adolescent Psychiatry University Psychiatric Practice Inc 462 Grider St Ste 1168 Buffalo NY 14215 Erie 7168984857

Page 21 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Smith, Beth A. Child & Adolescent Psychiatry University Psychiatric Practice Inc 3 Gates Cir 8th Fl Buffalo NY 14209 Erie 7168875800

Smith, Beth A. Child & Adolescent Psychiatry Kaleida Health 219 Bryant St 8th Fl Buffalo NY 14222 Erie 7168875800

Acquisto, Christopher J. Chiropractor Bryan S Aldrich 2179 Sheridan Dr Tonawanda NY 14223 Erie 7168742040

Adymy, Lawrence J. Chiropractor Adymy, Lawrence 1002 Lovejoy St Buffalo NY 14206 Erie 7168928811

Akiki, John V. Chiropractor Akiki, John 10440 Main St Clarence NY 14031 Erie 7167591478

Anzalone, Michael J. Chiropractor Anzalone, Michael J. 5449 Southwestern Blvd Hamburg NY 14075 Erie 7166464000

Anzalone, Michael J. Chiropractor Anzalone, Michael J. 100 College Pkwy Williamsville NY 14221 Erie 7166464000

Baase, Michael C. Chiropractor Baase, Michael 3868 E Robinson Rd Amherst NY 14228 Erie 7165642225

Baase, Michael C. Chiropractor Baase, Michael 2283 Grand Island Blvd Grand Island NY 14072 Erie 7167732222

Bader, C Robert C. Chiropractor Bader, C Robert 5050 Sheridan Dr Williamsville NY 14221 Erie 7166342802

Baumler, Gregory N. Chiropractor Baumler, Gregory 398 A Evans St Williamsville NY 14221 Erie 7166322200

Beck, Jonathan P. Chiropractor University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Beck, Jonathan P. Chiropractor Conover Chiropractic PC 2107 Eggert Rd Amherst NY 14226 Erie 7168310011

Beck, Jonathan P. Chiropractor University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Beck, Kenneth J. Chiropractor Beck, Kenneth 5864 Camp Rd Hamburg NY 14075 Erie 7166496944

Bialecki, John M. Chiropractor John M Bialecki DC 3140 Sheridan Dr Ste 215 Buffalo NY 14226 Erie 7162409365

Biasillo, Joseph F. Chiropractor Biasillo, Joseph 1064 Union Rd Ste 1 West Seneca NY 14224 Erie 7166770737

Blackman, Michael D. Chiropractor Blackman, Michael 841 Cleveland Dr Cheektowaga NY 14225 Erie 7168322593

Bowman, Adam Chiropractor Grand Island Chiropractic 2283 Grand Island Blvd Grand Island NY 14072 Erie 7167732222

Bowman, Adam Chiropractor Adam Bowman 3868 E Robinson Rd Amherst NY 14228 Erie 7165642225

Brenon, Jamie L. Chiropractor Jamie L Brenon 1088 Brighton Rd Tonawanda NY 14150 Erie 7168371711

Brooks, Rachel A. Chiropractor Scott Croce 369 Delaware Ave Buffalo NY 14202 Erie 7168471200

Buscaglia, Anthony J. Chiropractor Buscaglia Chiropractic 482 Two Rod Rd Alden NY 14004 Erie 7169377211

Butler, Joseph E. Chiropractor Western New York Chiropractic LLC 810 Center Rd West Seneca NY 14224 Erie 7166744254

Caprow, Steven R. Chiropractor Caprow, Steven 252 E Main St Springville NY 14141 Erie 7165924448

Caprow, Steven R. Chiropractor Caprow, Steven 1748 Hertel Ave Buffalo NY 14216 Erie 7168350066

Caruso, Anthony M. Chiropractor Caruso, Anthony 2577 Sheridan Dr Tonawanda NY 14150 Erie 7168328888

Ceier, Cynthia Chiropractor Ceier, Cynthia 2430 Bowen Rd Elma NY 14059 Erie 7166520541

Celotto, Steven J. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 1641 Hertel Ave Buffalo NY 14216 Erie 7166313555

Celotto, Steven J. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7169470139

Celotto, Steven J. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 13195 Broadway Alden NY 14004 Erie 7166313555

Celotto, Steven J. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Christopher, Matthew T. Chiropractor Christopher Matthew 350 Alberta Dr Ste 204 Amherst NY 14226 Erie 7167838778

Christopher, Michael R. Chiropractor Christopher, Michael 5842 Main St Williamsville NY 14221 Erie 7166265224

Cichocki, Jason D. Chiropractor Celotto, Steven 462 Grider St Buffalo NY 14215 Erie 7168983882

Cichocki, Jason D. Chiropractor Cichocki, Jason 345 Dick Rd Depew NY 14043 Erie 7166813333

Cichocki, Kevin E. Chiropractor Cichocki, Kevin 345 Dick Rd Depew NY 14043 Erie 7166813333

Ciura, Brendan J. Chiropractor Ciura, Brendan J. 450 Central Ave Ste 102 Lancaster NY 14086 Erie 7166836615

Clark, Zachery C. Chiropractor Clark, Zachery 4180 Abbott Rd Orchard Park NY 14127 Erie 7166466239

Coburn, Matthew Chiropractor Coburn, Matthew 1914 Colvin Blvd Tonawanda NY 14150 Erie 7168355000

Conover, Keith V. Chiropractor Conover Chiropractic PC 2107 Eggert Rd Amherst NY 14226 Erie 7168310011

Conrad, D Jordan Chiropractor Conrad, D Jordan 313 Elmwood Ave Buffalo NY 14222 Erie 7168828800

Conschafter, Gary W. Chiropractor Conschafter, Gary 337 Cleveland Dr Ste 1 Buffalo NY 14215 Erie 7168336225

Conschafter, Robert L. Chiropractor Conschafter, Robert 3795 Harlem Rd Buffalo NY 14215 Erie 7168385481

Cote, Matthew C. Chiropractor New York Chiropractic College 4974 Transit Rd Depew NY 14043 Erie 7168611005

Cox, Daniel C. Chiropractor Cox, Daniel 8370 Main St Williamsville NY 14221 Erie 7166323435

Cox, Daniel C. Chiropractor Adymy, Lawrence 1002 E Lovejoy St Buffalo NY 14206 Erie 7168928811

Cox, Stephanie Chiropractor Cox Family Chiropractic 3890 Seneca St Lower West Seneca NY 14224 Erie 7166743595

Coyle, Barbara A. Chiropractor Coyle, Barbara 5386 Sheridan Dr Williamsville NY 14221 Erie 7168345862

Coyle, Charles D. Chiropractor 1135 Maple Rd Buffalo NY 14221 Erie 7165651425

Croce, Scott A. Chiropractor Scott Croce 369 Delaware Ave Buffalo NY 14202 Erie 7168471200

Delucci, Raymond Chiropractor Delucci, Raymond 337 Cleveland Dr Buffalo NY 14215 Erie 7167838227

DeMarco, Lisa A. Chiropractor Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

DeMarco, Lisa A. Chiropractor Lisa DeMarco 345 Dick Rd Depew NY 14043 Erie 7166813333

Denecke, Thomas D. Chiropractor Denecke, Thomas 767 Mineral Springs Rd West Seneca NY 14224 Erie 7168231343

Dragonette, James J. Chiropractor Dragonette, James 4735 Southwestern Blvd Hamburg NY 14075 Erie 7166486161

Dragonette, Nicholas J. Chiropractor Dragonette, Nicholas 3405 S Orchard Pk Rd Orchard Park NY 14127 Erie 7166750515

Dragonette, Nicholas J. Chiropractor Dragonette, Nicholas S 3405 Orchard Park Rd Orchard Park NY 14127 Erie 7166750515

Dux, Mark A. Chiropractor Dux, Mark A. 1641 Hertel Ave Buffalo NY 14216 Erie 7168352225

Enzinna, Nicole M. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Enzinna, Nicole M. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 7060 Derby Rd Derby NY 14047 Erie 7169470139

Ess, Steven M. Chiropractor Rochester Chiropractic Assoc 8370 Main St Williamsville NY 14221 Erie 7166323435

Ferry, Mark A. Chiropractor Western New York Chiropractic LLC 810 Center Rd West Seneca NY 14224 Erie 7166744254

Ferry, Michael D. Chiropractor Infinite Health Chiropractic Wellness PC 3725 N Buffalo Rd Ste B Orchard Park NY 14127 Erie 7166672200

Fix, Jeffrey F. Chiropractor Fix, Jeffrey 246 Buffalo St Hamburg NY 14075 Erie 7166497082

Fix, Kathleen M. Chiropractor Fix, Kathleen 246 Buffalo St Hamburg NY 14075 Erie 7166497082

Page 22 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Formolo, Lance R. Chiropractor VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Frank, Thomas M. Chiropractor Frank, Thomas 4446 Main St Ste 100 Buffalo NY 14226 Erie 7168390047

Gaiser, John N. Chiropractor Gaiser, John 353 Kenmore Ave Buffalo NY 14223 Erie 7168340284

Gefaller, Ronald W. Chiropractor Gefaller, Ronald 3625 Eggert Rd Ste 104 Orchard Park NY 14127 Erie 7166744743

Gerow, Geoffrey J. Chiropractor Gerow, Geoffrey 449 E Ferry St Buffalo NY 14208 Erie 7168827701

Gillezeau, Paul M. Chiropractor Gillezeau Chiropratic PC 383 Big Tree Rd Hamburg NY 14075 Erie 7169806107

Goodspeed, Julie D. Chiropractor Chiro First Wellness 306 Abbott Rd Buffalo NY 14220 Erie 7168687836

Grande, Stephen A. Chiropractor Grande, Stephen 3685 Harlem Rd Cheektowaga NY 14215 Erie 7168344950

Grazen, Christopher A. Chiropractor Grazen, Christopher 450 Central Ave Ste 103 Lancaster NY 14086 Erie 7166816768

Grazen, Jeffrey R. Chiropractor Grazen, Jeffrey 450 Central Ave Ste 102 Lancaster NY 14086 Erie 7166836615

Grazen, Mark F. Chiropractor Grazen, Mark 450 Central Ave Ste 203 Lancaster NY 14086 Erie 7166816768

Green, Andrew C. Chiropractor Green, Andrew C. 3868 E Robinson Rd Amherst NY 14228 Erie 7165642225

Green, Andrew C. Chiropractor Grand Island Chiropractic 2283 Grand Island Blvd Grand Island NY 14072 Erie 7167732222

Guzinski, Peter J. Chiropractor Cichocki, Jason 345 Dick Rd Depew NY 14043 Erie 7166813333

Habermehl, Richard J. Chiropractor Habermehl, Richard 5449 Southwestern Blvd Hamburg NY 14075 Erie 7166464000

Hagen, Paul J. Chiropractor Hagen, Paul 2480 Niagara Falls Blvd Tonawanda NY 14150 Erie 7166922799

Herold, Andrea L. Chiropractor Herold, Andrea L. 146 Lake St Angola NY 14006 Erie 7165491999

Herr, Shannon T. Chiropractor Herr, Shannon T. 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7164805646

Herr, Shannon T. Chiropractor Warren A Marranca DC PC 1967 Wehrle Dr Ste 12 Williamsville NY 14221 Erie 7162048955

Higgins, Sean A. Chiropractor Higgins, Sean 3566 N Buffalo Rd Orchard Park NY 14127 Erie 7166620030

Holdnack, Eleanor Chiropractor Marciniak, Juliana M. 2625 Delaware Ave Ste 102 Buffalo NY 14216 Erie 7163359711

Hopkins, Bradley J. Chiropractor Hopkins, Bradley J. 5449 Southwestern Blvd Hamburg NY 14075 Erie 7166464000

Horner, Craig A. Chiropractor Horner, Craig 2470 Walden Ave Cheektowaga NY 14225 Erie 7166812968

Horner, Craig A. Chiropractor Horner, Craig 767 Mineral Springs Rd West Seneca NY 14224 Erie 7168231343

Horvath, Julius P. Chiropractor Horvath, Julius 264 Ontario St Buffalo NY 14207 Erie 7168733013

Hosmer, Keith L. Chiropractor Hosmer, Keith 154 Cazenovia St Buffalo NY 14210 Erie 7168245548

Impaglia III, Michael A. Chiropractor Optimum Chiropractic LLC 4729 Transit Rd Depew NY 14043 Erie 7166087075

Jafari, Ali M. Chiropractor Dr Ali M Jafari DC PC 711 Borden Rd Cheektowaga NY 14227 Erie 7166688108

Johnson, Daniel R. Chiropractor Johnson, Daniel 5660 Clinton St Elma NY 14059 Erie 7166747246

Jones, Phillip E. Chiropractor Creating Health Through Chiropractic 1064 Union Rd Ste 1 West Seneca NY 14224 Erie 7166770737

Joseph, Janelle Chiropractor New York Chiropractic College 4974 Transit Rd Depew NY 14043 Erie 7166859631

Kostek, Gary J. Chiropractor Kostek, Gary 8695 Sheridan Dr Williamsville NY 14221 Erie 7166344133

Krieger, William L. Chiropractor Krieger, William 5225 Sheridan Dr 2nd Fl Buffalo NY 14221 Erie 7166336044

Latona Brzezinski, Kristen M. Chiropractor Latona-Brzezinski, Kristen M. 8600 Main St Ste 2 Buffalo NY 14221 Erie 7166169000

Lindell, Darryl G. Chiropractor Lindell Chiropractic and Massage 928 French Rd Cheektowaga NY 14227 Erie 7166688021

Lines, Alan B. Chiropractor Lines, Alan 85 E Main St Springville NY 14141 Erie 7165922620

Littman, Cory J. Chiropractor Ken Ton Chiropractic Spine and Injury PC 2949 Elmwood Ave Ste 203 Buffalo NY 14217 Erie 7168742027

Lyons, Elizabeth T. Chiropractor Amherst Chiropractic, PC 1622 Hopkins Rd Williamsville NY 14221 Erie 7166890766

Lyons, Thomas G. Chiropractor Amherst Chiropractic, PC 1622 Hopkins Rd Williamsville NY 14221 Erie 7166890766

Magnano, Anthony P. Chiropractor Magnano, Anthony 810 Center Rd West Seneca NY 14224 Erie 7166744254

Marciniak, Juliana M. Chiropractor Marciniak, Juliana M. 2625 Delaware Ave Ste 102 Buffalo NY 14216 Erie 7163359711

Marconi, Louis Chiropractor Marconi, Louis 810 Center Rd West Seneca NY 14224 Erie 7166744254

Mardini, Amal Chiropractor Mardini, Amal 800 Niagara Falls Blvd Buffalo NY 14223 Erie 7168176729

Marranca, Warren A. Chiropractor University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Marranca, Warren A. Chiropractor Warren A Marranca DC PC 1967 Wehrle Dr Ste 12 Williamsville NY 14221 Erie 7162048955

Marranca, Warren A. Chiropractor University at Buffalo Neurosurgery Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162181000

Marranca, Warren A. Chiropractor Munroe Chiropractic 6035 Main St Williamsville NY 14221 Erie 7166324476

McAuliffe Ferry, Alaina E. Chiropractor Infinite Health Chiropractic Wellness PC 3725 N Buffalo Rd Ste B Orchard Park NY 14127 Erie 7166672200

McCourt, Brian M. Chiropractor McCourt Chiropractic 3681 Seneca St West Seneca NY 14224 Erie 7166754333

Mondschein, Keith D. Chiropractor Optimum Chiropractic of WNY 2577 Sheridan Dr Tonawanda NY 14150 Erie 7168331926

Mondschein, Keith D. Chiropractor Optimum Chiropractic of WNY 2470 Walden Ave Ste 2200 Cheektowaga NY 14225 Erie 7168331926

Morgante, Anthony V. Chiropractor Morgante, Anthony 1660 Kensington Ave Ste 4 Buffalo NY 14215 Erie 7168332960

Morgante, Theresa M. Chiropractor Morgante, Anthony 1660 Kensington Ave Ste 4 Buffalo NY 14215 Erie 7168332960

Morris, Nicholas J. Chiropractor New Health Chiropractic Associates PLLC 4154 McKinley Pkwy Ste 900 Buffalo NY 14219 Erie 7166498200

Muller, Chris J. Chiropractor Muller, Chris 3083 William St Cheektowaga NY 14227 Erie 7168942959

Munassar, Mohamed J. Chiropractor Mohammed J. Munassar, DC 4214 Clinton St West Seneca NY 14224 Erie 7169030008

Nassoiy, Elisa L. Chiropractor Elisa Nassoiy DC 101 Lang Blvd Grand Island NY 14072 Erie 7167740442

Niemiec, Katelyn Chiropractor Balanced Living Chiropractic 2140 Eggert Rd Ste B Amherst NY 14226 Erie 7168321818

Niemiec, Steven R. Chiropractor Balanced Living Chiropractic 2140 Eggert Rd Ste B Amherst NY 14226 Erie 7168321818

Notaro, Thomas J. Chiropractor Grand Island Chiropractic 3868 E Robinson Rd Amherst NY 14228 Erie 7165642225

Notaro, Thomas J. Chiropractor Grand Island Chiropractic 2283 Grand Island Blvd Grand Island NY 14072 Erie 7167732222

Nowak, John J. Chiropractor Nowak, John 817 Abbott Rd Buffalo NY 14220 Erie 7168254121

Nyrop, Jessica E. Chiropractor Nyrop, Jessica E. 5449 Southwestern Blvd Hamburg NY 14075 Erie 7166464000

Nyrop, Jessica E. Chiropractor Nyrop, Jessica E. 100 College Pkwy Williamsville NY 14221 Erie 7166464000

Owens, William J. Chiropractor Owens, William J. 191 North St Ste 104 Buffalo NY 14201 Erie 7162000651

Pais, Sasha M. Chiropractor Pais, Sasha M. 1567 Military Rd Kenmore NY 14217 Erie 7168770676

Page 23 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Palmer, William J. Chiropractor Buffalo Chiropractic Center 4729 Transit Rd Depew NY 14043 Erie 7166682225

Pantling, Craig Chiropractor Cox, Daniel 8370 Main St Williamsville NY 14221 Erie 7166323435

Pasier, John M. Chiropractor Pasier, John 3117 Abbott Rd Orchard Park NY 14127 Erie 7168282225

Pautler Bea, Stephanie R. Chiropractor Pautler, Stephanie 13305 Broadway St Alden NY 14004 Erie 7169025261

Pawelek, Steven M. Chiropractor Williamsville Family Chiropractic PC 154 Plaza Dr Williamsville NY 14221 Erie 7162768931

Petko, Carolyn Chiropractor Carolyn Petko DC 767 Mineral Springs Rd West Seneca NY 14224 Erie 7168231343

Phalen, Kevin Chiropractor Balanced Living Chiropractic 2140 Eggert Rd Ste B Amherst NY 14226 Erie 7168321818

Phelps, Charles Chiropractor Christopher, Michael 5842 Main St Williamsville NY 14221 Erie 7166265224

Phillips, David A. Chiropractor Phillips, David 5779 Broadway St Lancaster NY 14086 Erie 7166816750

Pignatora, Neal P. Chiropractor Ellicott Square Chiropractic PLLC 2075 Sheridan Dr Tonawanda NY 14223 Erie 7168522696

Pignatora, Neal P. Chiropractor Ellicott Square Chiropractic PLLC 295 Main St Ste 118 Buffalo NY 14203 Erie 7168522696

Pignatora, Neal P. Chiropractor Pignatora, Neal 295 Main St Ste 118 Buffalo NY 14203 Erie 7168522696

Przybyla, Luke A. Chiropractor Przybyla, Luke A. 1796 Clinton St Buffalo NY 14206 Erie 7168261661

Rae, Lindsay R. Chiropractor VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Rae, Lindsay R. Chiropractor VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Ribakove, David L. Chiropractor Ribakove, David 3407 Delaware Ave Kenmore NY 14217 Erie 7168775800

Ribakove, Tina L. Chiropractor Ribakove, Tina 3407 Delaware Ave Kenmore NY 14217 Erie 7168775800

Scharf, Brian Chiropractor Chiropractic Care PLLC 85 Franklin St Springville NY 14141 Erie 7165922923

Schleicher, Amy L. Chiropractor New York Chiropractic College 4974 Transit Rd Depew NY 14043 Erie 7166859631

Schuetze, Jennifer A. Chiropractor Snyder Sports and Chiropractic PLLC 3723 Harlem Rd Buffalo NY 14215 Erie 7169392787

Showalter, Scott D. Chiropractor Showalter, Scott D. 11881 Broadway Alden NY 14004 Erie 7169379870

Skraitz, Thomas Chiropractor Skraitz, Thomas 8370 Main St Williamsville NY 14221 Erie 7166323435

Smith, Gary R. Chiropractor Smith, Gary 5660 Clinton St Ste 4 Elma NY 14059 Erie 7166860868

Smith, Timothy A. Chiropractor Smith, Timothy 7174 Erie Rd Derby NY 14047 Erie 7169475106

Sokol, Lisa M. Chiropractor Sokol, Lisa M. 711 Borden Rd Cheektowaga NY 14227 Erie 7166688108

Sokolowski, Mark D. Chiropractor Sokolowski, Mark 5893 Camp Rd Ste 1 Hamburg NY 14075 Erie 7166483311

Sokolowski, Mark D. Chiropractor New York Chiropractic College 4974 Transit Rd Depew NY 14043 Erie 7166859631

Stevens, Gerald L. Chiropractor New York Chiropractic College 4974 Transit Rd Depew NY 14043 Erie 7166859631

Syracuse, Scott A. Chiropractor Syracuse Chiropractic PC 12364 Main Rd Akron NY 14001 Erie 7165423530

Taylor, John A. Chiropractor John A Taylor DC 2900 Main St Buffalo NY 14214 Erie 7165486343

Taylor, John A. Chiropractor John A Taylor DC 320 Porter Ave Buffalo NY 14201 Erie 7165486343

Tomko, Danielle V. Chiropractor Dr. Danielle V. Tomko DC 1567 Military Rd Kenmore NY 14217 Erie 7168770676

Toth, Andrew Chiropractor Christopher, Michael 5842 Main St Williamsville NY 14221 Erie 7166265224

Vaquero, Francisco A. Chiropractor South Buffalo Chiropractic LLC 1923 Seneca St Buffalo NY 14210 Erie 7168222225

Werder, Gerard J. Chiropractor Werder, Gerard 253 W Utica St Buffalo NY 14222 Erie 7168843019

Youngers, Scott A. Chiropractor Youngers, Scott 308 N Main St PO Box 325 Holland NY 14080 Erie 7165372676

Zappia, Jeffrey P. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 13195 Broadway Alden NY 14004 Erie 7169373150

Zappia, Jeffrey P. Chiropractor Michael K Landi MD dba Brain and Spine Medical Services 1641 Hertel Ave Buffalo NY 14216 Erie 7168352225

Ziarkowski, Richard E. Chiropractor Universal Chiropractic 1900 Ridge Rd Buffalo NY 14224 Erie 7166772969

Dabski, Christopher Clinical & Lab Dermat Christopher Dabski Md 1821 Como Pk Blvd Lancaster NY 14086 Erie 7166814800

Beck, Hiroko Clinical Cardiac Electrophy Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Beck, Hiroko Clinical Cardiac Electrophy Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7169619900

Beck, Hiroko Clinical Cardiac Electrophy Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Beck, Hiroko Clinical Cardiac Electrophy Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Beck, Hiroko Clinical Cardiac Electrophy Kaleida Health 100 High St Ste B-8 Buffalo NY 14203 Erie 7168597280

Beck, Hiroko Clinical Cardiac Electrophy Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Cai, John J. Clinical Cardiac Electrophy Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Cai, John J. Clinical Cardiac Electrophy Cai, John J. 515 Abbott Rd Ste 310 Buffalo NY 14220 Erie 7168282300

Curtis, Anne Clinical Cardiac Electrophy Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Curtis, Anne Clinical Cardiac Electrophy Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7168826544

Curtis, Anne Clinical Cardiac Electrophy Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Curtis, Anne Clinical Cardiac Electrophy Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Khan, Irfan Clinical Cardiac Electrophy Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Khan, Irfan Clinical Cardiac Electrophy Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Kim, Chee H. Clinical Cardiac Electrophy Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Kim, Chee H. Clinical Cardiac Electrophy Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301484

Kim, Chee H. Clinical Cardiac Electrophy Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Kim, Chee H. Clinical Cardiac Electrophy Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301484

Ozcan, Cevher Clinical Cardiac Electrophy Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Ozcan, Cevher Clinical Cardiac Electrophy Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ozcan, Cevher Clinical Cardiac Electrophy Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ozcan, Cevher Clinical Cardiac Electrophy Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Rozmus, Grzegorz P. Clinical Cardiac Electrophy Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983388

Saito, Yuji Clinical Cardiac Electrophy Cardiographic Associates 2605 Harlem Rd Buffalo NY 14225 Erie 7168912420

Saito, Yuji Clinical Cardiac Electrophy Bruce L Platt MD PC 1616 Kensington Ave Buffalo NY 14215 Erie 7168343278

Saito, Yuji Clinical Cardiac Electrophy Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621759

Page 24 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Saito, Yuji Clinical Cardiac Electrophy Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Switzer, Donald F. Clinical Cardiac Electrophy TCD Medical Testing PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7162502002

Switzer, Donald F. Clinical Cardiac Electrophy Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301484

Switzer, Donald F. Clinical Cardiac Electrophy Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301484

Zador, Stephen T. Clinical Cardiac Electrophy Zador, Stephen 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Kanehira, Kazunori Clinical Cytogenetics Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168455785

Erbe, Richard W. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787105

Erbe, Richard W. Clinical Genetics - MD University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Erbe, Richard W. Clinical Genetics - MD University at Buffalo Pathologists PC 936 Delaware Ave Buffalo NY 14209 Erie 7168787440

Erbe, Richard W. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787105

Erbe, Richard W. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc PO Box 2113 Buffalo NY 14222 Erie 7168781570

Erbe, Richard W. Clinical Genetics - MD University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168292846

Robinson, Luther K. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 936 Delaware Ave Buffalo NY 14209 Erie 7168787595

Robinson, Luther K. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787105

Robinson, Luther K. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc PO Box 2113 Buffalo NY 14222 Erie 7168781570

Robinson, Luther K. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787530

Robinson, Luther K. Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 936 Delaware St Buffalo NY 14209 Erie 7168787595

Robinson, Luther K. Clinical Genetics - MD Kaleida Health 461 William St Town Garden Pediatrics Clinic Buffalo NY 14206 Erie 7168521578

Sadler, Laurie Clinical Genetics - MD University at Buffalo Pediatric Associates Inc 140 Hodge 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787105

Sadler, Laurie Clinical Genetics - MD University at Buffalo Pediatric Associates Inc Genetics 219 Bryant St Buffalo NY 14222 Erie 7168787105

Voian, Nicoleta C. Clinical Genetics - MD Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ferguson, Richard E. Clinical Neurophysiology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168875410

Ferguson, Richard E. Clinical Neurophysiology Ferguson, Richard 180 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7166555454

Ferguson, Richard E. Clinical Neurophysiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Ferguson, Richard E. Clinical Neurophysiology Ferguson, Richard 771 Main St East Aurora NY 14052 Erie 7166555454

Fine, Edward J. Clinical Neurophysiology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Fine, Edward J. Clinical Neurophysiology Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Fine, Edward J. Clinical Neurophysiology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Fine, Edward J. Clinical Neurophysiology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Fine, Edward J. Clinical Neurophysiology Univ Neurology Inc 300 Essjay Rd Buffalo NY 14226 Erie 7169326080

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 300 Essjay Rd Buffalo NY 14221 Erie 7169326080

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 3 Gates Cir Buffalo NY 14205 Erie 7168875410

Finnegan, Sarah G. Clinical Neurophysiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787840

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168597511

Finnegan, Sarah G. Clinical Neurophysiology Kaleida Health 4955 N Bailey Ave Buffalo NY 14221 Erie 7168597511

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168597511

Finnegan, Sarah G. Clinical Neurophysiology Univ Neurology Inc 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Roehmholdt, Mary E. Clinical Neurophysiology Mary Elizabeth Roehmholdt 300 Essjay Rd Ste 105 Williamsville NY 14221 Erie 7166346357

Sambuchi, Gregory D. Clinical Neurophysiology Terrace View 462 Grider St Neurology Clinic Buffalo NY 14215 Erie 7168983000

Albert, Michael S. Clinical Pathology Eastern Great Lakes Pathology Pc 565 Abbott Rd Mercy Hospital Buffalo NY 14220 Erie 7168282401

Albert, Michael S. Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

Albert, Michael S. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168628657

Albert, Michael S. Clinical Pathology Eastern Great Lakes Pathology Pc 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Arshad, Ayesha Clinical Pathology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Arshad, Ayesha Clinical Pathology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Asirwatham, John E. Clinical Pathology Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Asirwatham, John E. Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

Asirwatham, John E. Clinical Pathology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Asirwatham, John E. Clinical Pathology Buffalo Emergency Associates 55 Melroy Ave Lackawanna NY 14218 Erie 7168258000

Balos, Lucia L. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Balos, Lucia L. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14209 Erie 7168595600

Barbarossa, Frank J. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592846

Barbarossa, Frank J. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Barcos, Maurice P. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Barcos, Maurice P. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Becker, Joanne Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Bogner, Paul N. Clinical Pathology Assoc Plastic Surgeons Of Wny Pc 5611 Main St Williamsville NY 14221 Erie 7166318500

Bogner, Paul N. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Cheney, Richard T. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Chopra, Usha G. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168628657

Chopra, Usha G. Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

Chopra, Usha G. Clinical Pathology Eastern Great Lakes Pathology Pc 565 Abbott Rd Buffalo NY 14240 Erie 7168283511

Chopra, Usha G. Clinical Pathology Eastern Great Lakes Pathology Pc 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Page 25 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Crossland, David M. Clinical Pathology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 5186266985

Errick, Janice E. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168628657

Errick, Janice E. Clinical Pathology Eastern Great Lakes Pathology Pc 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Errick, Janice E. Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

Errick, Janice E. Clinical Pathology Eastern Great Lakes Pathology Pc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476237

Garner, Kelly J. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main st Buffalo NY 14214 Erie 7168621000

Garner, Kelly J. Clinical Pathology Eastern Great Lakes Pathology Pc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gelfer, Frida Clinical Pathology Eastern Great Lakes Pathology Pc 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Gelfer, Frida Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

George, Mary D. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592281

George, Mary D. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Habermann, Joann Clinical Pathology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Hertzog, Robert W. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168292846

Hertzog, Robert W. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Iancu, Dan M. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kanehira, Kazunori Clinical Pathology Kanehira, Kazunori Elm and Carlton St Buffalo NY 14263 Erie 7168455785

Kasznica, John M. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Buffalo NY 14263 Erie 7168452300

Khoury, Thaer Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kozielski, Rafal Clinical Pathology University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7166267944

Krabill, Keith Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Krabill, Keith Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592846

Levea, Charles M. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Marchetti, Elizabeth A. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Marchetti, Elizabeth A. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Mazariegos, Juan D. Clinical Pathology Buffalo Emergency Associates 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Mazariegos, Juan D. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168628657

Mazariegos, Juan D. Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

Mazariegos, Juan D. Clinical Pathology Eastern Great Lakes Pathology Pc Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282401

Mojica, Wilfrido D. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592846

Mojica, Wilfrido D. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Murphy, Marianne B. Clinical Pathology Eastern Great Lakes Pathology Pc 100 High St Buffalo NY 14203 Erie 7168592846

Nakhla, Hassan Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592140

Neppalli, Vishala T. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ostrow, Peter Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592281

Petras, Melissa L. Clinical Pathology University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Petras, Melissa L. Clinical Pathology University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Petras, Melissa L. Clinical Pathology University at Buffalo Pathologists PC 115 Flint Rd Williamsville NY 14221 Erie 7166267200

Petras, Melissa L. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Qiu, Jingxin Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Samuel, Rana Clinical Pathology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Sands, Amy M. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7166267944

Satchidanand, Sateesh K. Clinical Pathology Eastern Great Lakes Pathology Pc 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Satchidanand, Sateesh K. Clinical Pathology University at Buffalo Pathologists PC 100 High St Neurosurgery Dept Buffalo NY 14203 Erie 7168595600

Satchidanand, Sateesh K. Clinical Pathology Eastern Great Lakes Pathology Pc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Satchidanand, Sateesh K. Clinical Pathology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283528

Satchidanand, Sateesh K. Clinical Pathology Parkside Anesthesia Associates PC 2157 Main St Buffalo NY 14214 Erie 7168621759

Satchidanand, Sateesh K. Clinical Pathology Gastroenterology Associates LLP 60 Maple Rd Ste 1 Williamsville NY 14221 Erie 7166265250

Scamurra, David O. Clinical Pathology Eastern Great Lakes Pathology Pc 60 Pineview Dr Amherst NY 14228 Erie 7162509235

Scamurra, David O. Clinical Pathology Eastern Great Lakes Pathology Pc 3385 Bailey Ste 4 Buffalo NY 14215 Erie 7168310030

Scamurra, David O. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168628657

Scamurra, David O. Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912404

Scamurra, David O. Clinical Pathology Eastern Great Lakes Pathology Pc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Scamurra, David O. Clinical Pathology Eastern Great Lakes Pathology Pc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476237

Slate II, Donald M. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592846

Starostik, Petr Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm Carlton St Buffalo NY 14263 Erie 7168452300

Stefanick, Barbara K. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168621000

Sule, Norbert Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Tomaszewski, John E. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Tomaszewski, John E. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Truskinovsky, Alexander M. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm And Carlton Sts Buffalo NY 14263 Erie 7168452300

Velazquez, Francisco Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592281

Velazquez, Francisco Clinical Pathology University at Buffalo Pathologists PC William E Mosher Hlth Ctr 899 Main St Buffalo NY 14203 Erie 7168782700

Woytash, James J. Clinical Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168592281

Woytash, James J. Clinical Pathology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Woytash, James J. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Xu, Bo Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Page 26 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Ylagan, Lourdes R. Clinical Pathology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Yoon, Sigmund S. Clinical Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Yoon, Sigmund S. Clinical Pathology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Zeid, Mohamed Y. Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168621000

Zhao, Jia Clinical Pathology Buffalo Emergency Associates 55 Melroy Ave Lackawanna NY 14218 Erie 7168258000

Zhao, Jia Clinical Pathology Eastern Great Lakes Pathology Pc 565 Abbott Rd Buffalo NY 14220 Erie 7168282401

Zhao, Jia Clinical Pathology Eastern Great Lakes Pathology Pc 2157 Main St Buffalo NY 14214 Erie 7168621000

Zhao, Jia Clinical Pathology Eastern Great Lakes Pathology Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Zhao, Jia Clinical Pathology Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 7166367800

Zhao, Jia Clinical Pathology Eastern Great Lakes Pathology Pc 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476237

Zhou, Young T. Clinical Pathology Gastroenterology Associates LLP 60 Maple Rd Ste 1 Williamsville NY 14221 Erie 7166265250

Adams, Timothy M. Colon & Rectal Surgery Delaware Surgical Grp Pc 3 Gates Cir Buffalo NY 14209 Erie 7166369004

Adams, Timothy M. Colon & Rectal Surgery Delaware Surgical Grp Pc 1150 Youngs Rd Ste 202 Williamsville NY 14221 Erie 7166369004

Adams, Timothy M. Colon & Rectal Surgery Kaleida Health 100 High St D3 Colen Rectal Clinic Buffalo NY 14203 Erie 7168592524

Attuwaybi, Bashir O. Colon & Rectal Surgery Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301081

Attuwaybi, Bashir O. Colon & Rectal Surgery Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Attuwaybi, Bashir O. Colon & Rectal Surgery Buffalo Medical Group 4955 N Bailey Ave Amherst NY 14226 Erie 7166301081

Attuwaybi, Bashir O. Colon & Rectal Surgery Kaleida Health 6255 Sheridan Dr Ste 304 Williamsville NY 14221 Erie 7168592514

Attuwaybi, Bashir O. Colon & Rectal Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Boehmke, Fred E. Colon & Rectal Surgery Amherst Colon & Rectal Surgery 8201 Main St Ste 8 Williamsville NY 14221 Erie 7166266626

Boehmke, Fred E. Colon & Rectal Surgery Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482420

Cywinski, Matthew J. Colon & Rectal Surgery Kaleida Health 100 High St D3 Buffalo NY 14203 Erie 7168592524

Cywinski, Matthew J. Colon & Rectal Surgery Buffalo Medical Group 4955 N Bailey Ave Amherst NY 14226 Erie 7168344237

Haley, Timothy D. Colon & Rectal Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592524

Kulaylat, Mahmoud N. Colon & Rectal Surgery University at Buffalo Surgeons Inc 100 High St 3rd Fl Buffalo NY 14203 Erie 7168592050

Kulaylat, Mahmoud N. Colon & Rectal Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Kulaylat, Mahmoud N. Colon & Rectal Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Leberer, Joseph P. Colon & Rectal Surgery Buffalo Medical Group 4955 N Bailey Ave Amherst NY 14226 Erie 7168344237

Leberer, Joseph P. Colon & Rectal Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592524

Matier, Brian Colon & Rectal Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578781

Matier, Brian Colon & Rectal Surgery Kaleida Health 100 High St D3 Specialty Clinic Buffalo NY 14203 Erie 7168592524

Radolinski, Adam Colon & Rectal Surgery Radolinski, Adam 888 Center Rd West Seneca NY 14224 Erie 7166753530

Singh, Amarjit Colon & Rectal Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578606

Singh, Amarjit Colon & Rectal Surgery Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7168578606

Singh, Amarjit Colon & Rectal Surgery Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168221750

Teng, Brian P. Colon & Rectal Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Udagawa, Salvador M. Colon & Rectal Surgery Udagawa, Salvador 3404 Main St Buffalo NY 14214 Erie 7168350641

Visco, Jeffrey J. Colon & Rectal Surgery Kaleida Health 100 High St D3 Buffalo NY 14203 Erie 7168592524

Visco, Jeffrey J. Colon & Rectal Surgery Kaleida Health 6255 Sheridan Dr Ste 304 Williamsville NY 14221 Erie 7168592524

Visco, Jeffrey J. Colon & Rectal Surgery Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7168578751

Visco, Jeffrey J. Colon & Rectal Surgery Buffalo Medical Group 4955 N Bailey Ave Amherst NY 14226 Erie 7168344237

Anillo, Sergio J. Critical Care Medicine Buffalo Internist & Associates LLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Anillo, Sergio J. Critical Care Medicine Kaleida Health PO Box 8000 Dept 164 Buffalo NY 14267 Erie 7166923302

Anillo, Sergio J. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm And Carlton Sts Buffalo NY 14263 Erie 7168452300

Buscaglia, Anthony J. Critical Care Medicine Buscaglia, Anthony 5451 Southwestern Blvd Hamburg NY 14075 Erie 7166493638

Buscaglia, Anthony J. Critical Care Medicine Buscaglia, Anthony 565 ABBOTT RD Buffalo NY 14220 Erie 7168240266

Buscaglia, Anthony J. Critical Care Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282180

Buscaglia, Anthony J. Critical Care Medicine Buscaglia, Anthony 515 Abbott Rd Ste 102 C Buffalo NY 14220 Erie 7168240266

Campbell, Lucy A. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Cohen, Ian L. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Cohen, Ian L. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical 100 High St Buffalo NY 14203 Erie 7168592349

Cohen, Ian L. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168593599

D Arcy, Brian J. Critical Care Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dharshan, Ananda C. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Dhillon, Samjot S. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Diringer, Erik J. Critical Care Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Durante, David J. Critical Care Medicine Durante, David 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166770850

Edelson, Jonathan S. Critical Care Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Edelson, Jonathan S. Critical Care Medicine The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

El Solh, Ali A. Critical Care Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

El Solh, Ali A. Critical Care Medicine Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983333

Ewing, Peter D. Critical Care Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Ewing, Peter D. Critical Care Medicine Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ewing, Peter D. Critical Care Medicine Kaleida Health 100 High St Rm 1437 Buffalo NY 14203 Erie 7168592259

Ewing, Peter D. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168984808

Fitzpatrick, James M. Critical Care Medicine Fitzpatrick, James 2950 Elmwood Ave Kmh 2nd Fl Buffalo NY 14217 Erie 7168768760

Page 27 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Freundel, Anthony D. Critical Care Medicine Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7162622400

Freundel, Anthony D. Critical Care Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Freundel, Anthony D. Critical Care Medicine The Pulmonary Grp Of W Ny 2699 Wehrle Dr Buffalo NY 14221 Erie 7166323700

Freundel, Anthony D. Critical Care Medicine The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

Freundel, Anthony D. Critical Care Medicine Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168875310

Gibbons, William J. Critical Care Medicine Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168592271

Gibbons, William J. Critical Care Medicine Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597278

Gibbons, William J. Critical Care Medicine Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Gleason, Bonnie T. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Gothgen, Niels U. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592260

Gothgen, Niels U. Critical Care Medicine IPC Hospitalist Services of New York, PC 5775 Maelou Dr Hamburg NY 14075 Erie 7168498750

Gothgen, Niels U. Critical Care Medicine IPC Hospitalist Services of New York, PC 1503 Military Rd Buffalo NY 14217 Erie 7168498750

Gough, Michael S. Critical Care Medicine Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gough, Michael S. Critical Care Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Grant, Brydon J. Critical Care Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Hung, Yin Fei Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Jaoude, Philippe E. Critical Care Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 640 Ellicott St Buffalo NY 14203 Erie 7169237326

Jaoude, Philippe E. Critical Care Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 1120 Youngs Rd Williamsville NY 14221 Erie 7169237326

Jaoude, Philippe E. Critical Care Medicine Kaleida Health 100 High St B8 The Heart and Lung Center Buffalo NY 14203 Erie 7168597280

Jaoude, Philippe E. Critical Care Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301000

Jaoude, Philippe E. Critical Care Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 4090 Seneca St West Seneca NY 14224 Erie 7169237326

Jaoude, Philippe E. Critical Care Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 1491 Sheridan Dr Kenmore NY 14223 Erie 7169237326

Jaoude, Philippe E. Critical Care Medicine Buffalo Medical Group 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7168578666

Jaoude, Philippe E. Critical Care Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301000

Jaoude, Philippe E. Critical Care Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 219 Bryant St Buffalo NY 14222 Erie 7169237326

Jaoude, Philippe E. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Khan, Mohammad A. Critical Care Medicine Niagara Pulmonary & Sleep Medicine PC 5451 Southwestern Blvd Hamburg NY 14075 Erie 7166493638

Khan, Mohammad A. Critical Care Medicine Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Khan, Mohammad A. Critical Care Medicine Niagara Pulmonary & Sleep Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Mammen, Manoj J. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Mammen, Manoj J. Critical Care Medicine Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Mammen, Manoj J. Critical Care Medicine Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Mango, Laura J. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Nadler, Jamie N. Critical Care Medicine Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Nadler, Jamie N. Critical Care Medicine Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Nadler, Jamie N. Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592260

Nadler, Jamie N. Critical Care Medicine Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597280

Namassivaya, Nalini J. Critical Care Medicine Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Noghrehkar, Dena Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Parashar, Akash Critical Care Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Parashar, Akash Critical Care Medicine Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Pietrantoni, Celestino Critical Care Medicine Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Rabadi, Nashat H. Critical Care Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301100

Rabadi, Nashat H. Critical Care Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Rabadi, Nashat H. Critical Care Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301100

Sherif, Sherif M. Critical Care Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578629

Sherif, Sherif M. Critical Care Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7168578629

Shetty, Mahesh J. Critical Care Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ten Brock, Eric Critical Care Medicine Academic Medicine Services 4893 Transit Rd Depew NY 14043 Erie 7163483435

Ten Brock, Eric Critical Care Medicine Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168592271

Ten Brock, Eric Critical Care Medicine Academic Medicine Services 310 Sterling Dr Orchard Park NY 14127 Erie 7163483435

Ten Brock, Eric Critical Care Medicine Academic Medicine Services 4511 Harlem Rd Ste 202 Amherst NY 14226 Erie 7169294654

Ten Brock, Eric Critical Care Medicine Academic Medicine Services 6105 Transit Rd The Sleep Ctr East Amherst NY 140512611 Erie 7163483435

Ten Brock, Eric Critical Care Medicine Kaleida Health 100 High St Ste B8 Buffalo NY 14203 Erie 7168597280

Vivona, Joan A. Critical Care Medicine Vivona, Joan 565 Abbott Rd Buffalo NY 14220 Erie 7168282666

Vivona, Joan A. Critical Care Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Soofi, Yousef Cytopathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Accetta, Peter J. Dermatology Accetta, Peter 3045 Southwestern Blvd Ste 104 Orchard Park NY 14127 Erie 7166757000

Altman, David J. Dermatology Altman, David 8421 Sheridan Dr Williamsville NY 14221 Erie 7168100610

Amarante, Lynn A. Dermatology Lynn A Amarante Md Pc 5144 Sheridan Dr Buffalo NY 14221 Erie 7166322311

Burden, Patricia A. Dermatology Burden, Patricia A. 5782 Main St Ste 1 Williamsville NY 14221 Erie 7163321620

Buscaglia, Daniel A. Dermatology Daniel Buscaglia 52 S Union Rd Ste 203 Williamsville NY 14221 Erie 7168395851

Conroy, Elizabeth A. Dermatology Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301465

Conroy, Elizabeth A. Dermatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Dabski, Christopher Dermatology Christopher Dabski Md 1821 Como Pk Blvd Lancaster NY 14086 Erie 7166814800

Dee, Anthony S. Dermatology Dee, Anthony 9276 Main St Ste 1A Clarence NY 14031 Erie 7167597759

Page 28 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Dhafir, Mazin A. Dermatology Dhafir, Mazin 4085 Seneca St Ste 3 West Seneca NY 14224 Erie 7166741180

Esler Brauer, Lisa Dermatology Daniel Buscaglia 52 S Union Rd Ste 203 Williamsville NY 14221 Erie 7168395851

Grassi, Marcelle A. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Grassi, Marcelle A. Dermatology Grassi, Marcelle 2560 Walden Ave Ste 107 Cheektowaga NY 14225 Erie 7166510726

Grassi, Marcelle A. Dermatology UB Family Medicine Inc 8207 Main St Ste 14 Williamsville NY 14221 Erie 7162045350

Hassanali, Riyaz Dermatology Hassanali, Riyaz 811 Maple Rd Williamsville NY 14221 Erie 7166261593

Helm, Thomas N. Dermatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Housel, Joseph P. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Jones, Cornelie M. Dermatology BD Wilson MD & Associates 17 Long Ave Ste 200 201 Hamburg NY 14075 Erie 7166482770

Jones, Cornelie M. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Kalb, Robert E. Dermatology Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301102

Kalb, Robert E. Dermatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Kulick, Kevin B. Dermatology Kulick, Kevin 3839 Delaware Ave Kenmore NY 14217 Erie 7168742134

Kulick, Kevin B. Dermatology Buffalo Medical Group 3839 Delaware Ave Buffalo NY 14217 Erie 7168742134

Lema, Bethany S. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Lema, Bethany S. Dermatology Daniel Buscaglia 52 S Union Rd Ste 203 Buffalo NY 14221 Erie 7166325200

Lenahan, Mary L. Dermatology Lenahan, Mary 6507 Transit Rd East Amherst NY 14051 Erie 7166894377

Levis, William R. Dermatology UB Family Medicine Inc 8207 Main St Ste 14 Williamsville NY 14221 Erie 7162045350

Miller, Craig C. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Streets Buffalo NY 14263 Erie 7168452300

Mogavero Jr, Herman S. Dermatology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578615

Myers, David E. Dermatology UB Family Medicine Inc 300 Essjay Rd Ste 100 Williamsville NY 14221 Erie 7162045350

Myers, David E. Dermatology Kaleida Health 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Myers, David E. Dermatology Myers, David 353 Kenmore Ave Buffalo NY 14223 Erie 7168320740

Nazareth, Michael R. Dermatology Western New York Dermatology PLLC 297 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7168312600

Neiman, Joseph B. Dermatology Neiman, Joseph 1140 Youngs Rd Williamsville NY 14221 Erie 7166880020

O Neill, Jenna L. Dermatology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564829

Paragh, Gyorgy Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ramsdell, Anne M. Dermatology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Rothman, Ilene L. Dermatology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Rothman, Ilene L. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Rothman, Ilene L. Dermatology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787172

Samuel, Rana Dermatology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

SantaLucia, Peter Dermatology BD Wilson MD & Associates 17 Long Ave Ste 200 and 201 Hamburg NY 14075 Erie 7166482770

Sinha, Animesh A. Dermatology UB Family Medicine Inc 8207 Main St Ste 14 Williamsville NY 14221 Erie 7162045350

Tarfare, Nathmal S. Dermatology Tarfare, Nathmal S 4947 Lake Shore Rd Hamburg NY 14075 Erie 7166274407

Tausk, Francisco A. Dermatology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ullman, Lori E. Dermatology Buffalo Medical Group 6245 Sheridan Dr Ste 316 Williamsville NY 14221 Erie 7166301136

Ureta, Laura Dermatology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564899

Ureta, Laura Dermatology Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Ureta, Laura Dermatology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578622

Wilson, Brummitte D. Dermatology BD Wilson MD & Associates 17 Long Ave Ste 200 and 201 Hamburg NY 14075 Erie 7166482770

Wirth, Paul B. Dermatology Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Wirth, Paul B. Dermatology Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301465

Dabski, Christopher Dermatopathology Christopher Dabski Md 1821 Como Pk Blvd Lancaster NY 14086 Erie 7166814800

Helm, Thomas N. Dermatopathology Buffalo Medical Group 6255 Sheridan Dr Ste 208A Williamsville NY 14221 Erie 7166302582

Helm, Thomas N. Dermatopathology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Lin, Lin Dermatopathology Buffalo Medical Group 6255 Sheridan Dr Ste 208a Williamsville NY 14221 Erie 7166302582

Hoffman, Martin T. Development Behavioral Ped Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781268

Hoffman, Martin T. Development Behavioral Ped Kaleida Health 461 William St Town Garden Pediatric Clinic Buffalo NY 14206 Erie 7168521578

Hoffman, Martin T. Development Behavioral Ped University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787288

Hoffman, Martin T. Development Behavioral Ped University at Buffalo Pediatric Associates Inc Town Garden Plz 461 William St Ste 5 Buffalo NY 14204 Erie 7168521578

Hoffman, Martin T. Development Behavioral Ped University at Buffalo Pediatric Associates Inc Town Gardens Pediatric Clinic 461 William St Ste 5 Buffalo NY 14202 Erie 7168521578

Hoffman, Martin T. Development Behavioral Ped Kaleida Health 125 Hodge St Buffalo NY 14222 Erie 7168787488

Hoffman, Martin T. Development Behavioral Ped University at Buffalo Pediatric Associates Inc Diefendorf 106 3435 Main St Buffalo NY 14214 Erie 7168292244

Hoffman, Martin T. Development Behavioral Ped University at Buffalo Pediatric Associates Inc West Side Clnc 300 Niagara St Buffalo NY 14202 Erie 7168594180

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14211 Erie 8008410417

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Page 29 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Feld, Gregg I. Diagnostic Radiology w/Nuclear Rad Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

Adams, Cristine M. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Clemency, Brian M. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

DeFazio, Christian R. Emergency Medical Srvs Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

DeFazio, Christian R. Emergency Medical Srvs Professional Emergency Services PLLC 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Ellis, David A. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Galarneau, Jason Emergency Medical Srvs Keystone Medical Service Of NY 224 E Main St Springville NY 14141 Erie 7165922871

Hughes, David P. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Jin, Ken Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Koenig, Benjamin O. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Livshits, Zhanna Emergency Medical Srvs Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Livshits, Zhanna Emergency Medical Srvs Buffalo Emergency Associates 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Livshits, Zhanna Emergency Medical Srvs Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Livshits, Zhanna Emergency Medical Srvs Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Livshits, Zhanna Emergency Medical Srvs Buffalo Emergency Associates 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Lynch, Joshua J. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Manka Jr, Michael A. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Myers, Jeffrey W. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Neely, Cheryl L. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Paul, Sucharita Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Piazza, Gina M. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Sieminski, Mark M. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Sieminski, Mark M. Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Wiech, Carolyn Emergency Medical Srvs VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Abrahams, Wayne A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Adams, Cristine M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Adams, Cristine M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Adams, Cristine M. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Adams, Cristine M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Afoh Manin, Nanaefua B. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7162044500

Ahmed, Qadeer Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787909

Alizray, Imad G. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Mercy Hosp ER Dept Buffalo NY 14220 Erie 9048051010

Alizray, Imad G. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore Mercy Hosp Kenmore NY 14217 Erie 7164476100

Alizray, Imad G. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Mercy Ambulatory Orchard Park NY 14127 Erie 7166620500

Alizray, Imad G. Emergency Medicine Buffalo Emergency Associates 2157 Main St Sisters of Charity Hosp Buffalo NY 14214 Erie 7168621000

Alizray, Imad G. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd St Joseph Hosp Cheektowaga NY 14225 Erie 7168912400

Argentieri, Jennifer A. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Argentieri, Jennifer A. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Baggett, Michael A. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Baggett, Michael A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Baranello, Pat J. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Barker, Jason K. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14202 Erie 7166918838

Barker, Jason K. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Barone, William D. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Barone, William D. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Barrett, Matthew J. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Barrett, Matthew J. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Barron, Martin Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bart, Joseph A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bart, Joseph A. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Basior, Jeanne M. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Basior, Jeanne M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Basior, Jeanne M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Basior, Jeanne M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Batt, Kathleen M. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7166918838

Batt, Kathleen M. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7166918838

Batt, Kathleen M. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Page 30 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Batt, Kathleen M. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Batt, Kathleen M. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7166918838

Batt, Kathleen M. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7166918838

Behrens, Torsten Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Behrens, Torsten Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Behrens, Torsten Emergency Medicine FDR Medical Services PC 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Belote, Scott J. Emergency Medicine FDR Medical Services PC 462 Grider St Buffalo NY 14215 Erie 7168984169

Belote, Scott J. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bennett, Mary K. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Bennett, Mary K. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Bennett, Mary K. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bennett, Mary K. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Bertolino, Jack G. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Bertolino, Jack G. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Bertolino, Jack G. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Bertolino, Jack G. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Billings, Nathaniel P. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Billittier, Anthony J. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983525

Bingeman, Dawn M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Bingeman, Dawn M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Bingeman, Dawn M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bitar, Souad Y. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Bitar, Souad Y. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Bitar, Souad Y. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Bitar, Souad Y. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Bitar, Souad Y. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Bordonaro, Samantha F. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Bordonaro, Samantha F. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7165801815

Bordonaro, Samantha F. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Bordonaro, Samantha F. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Bordonaro, Samantha F. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7165801815

Bordonaro, Samantha F. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Bordonaro, Samantha F. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Bordonaro, Samantha F. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Borke, Jesse A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Borton, Jason A. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Borton, Jason A. Emergency Medicine MFHS Physicians Emerg Svcs PC 1540 Maple Rd Williamsville NY 14221 Erie 7166883107

Borton, Jason A. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Borton, Jason A. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Borton, Jason A. Emergency Medicine MedFirst Urgent Care PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166883107

Borton, Jason A. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Borton, Jason A. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Borton, Jason A. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Borton, Jason A. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Borton, Jason A. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Bouton, Scott M. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Bouton, Scott M. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Bozer, Paula R. Emergency Medicine Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482180

Brach, John A. Emergency Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Brach, John A. Emergency Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Bradfield McGee, Kristina R. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Bradfield McGee, Kristina R. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Braen, George R. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Braen, George R. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Braen, George R. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14240 Erie 7168983000

Braen, George R. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Brockman, Daniel S. Emergency Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7169616995

Brockman, Daniel S. Emergency Medicine Buffalo Internist & Associates LLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Brockman, Daniel S. Emergency Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7168172938

Brockman, Daniel S. Emergency Medicine Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7168983000

Brown, Jennifer L. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Brown, Jennifer L. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983525

Brown, Kevin R. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 8668987117

Brown, Lloyd W. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Brown, Lloyd W. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168282666

Brown, Lloyd W. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Page 31 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Buege, Kathryne L. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Buege, Kathryne L. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Buege, Kathryne L. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7165801813

Buege, Kathryne L. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Bukhari, Syed W. Emergency Medicine Elder Medical Services PC 1503 Military Rd Kenmore NY 14217 Erie 7164476600

Bukhari, Syed W. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Bukhari, Syed W. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Bukhari, Syed W. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Bukhari, Syed W. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Bukhari, Syed W. Emergency Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Cheektowaga NY 14225 Erie 7162049711

Burke, Amy J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Burke, Amy J. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7168340700

Burke, Amy J. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7166918838

Burns, Thomas F. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Buscaglia, Anthony L. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168282666

Camba, Victoria A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Carnevale, Frank P. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Carnevale, Frank P. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Carter, John M. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Cir Buffalo NY 14209 Erie 7166918838

Carter, John M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Carter, John M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Carter, John M. Emergency Medicine Buffalo Emergency Associates 462 Grider St Buffalo NY 14215 Erie 7168983000

Carter, John M. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Cassel, Kerry Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Cassel, Kerry Emergency Medicine VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7172776565

Cassel, Kerry Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983478

Cassel, Kerry Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Cassel, Kerry Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Cassel, Kerry Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168591993

Cassel, Kerry Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Celentano, James J. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Celentano, James J. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Celentano, James J. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Celentano, James J. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Celentano, James J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 2123052995

Cheslock, Timothy J. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Clemency, Brian M. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Clemency, Brian M. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Cloud, Samuel D. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Conley, Liza E. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7166918838

Conley, Liza E. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7168340700

Conley, Liza E. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Conley, Liza E. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7166918838

Conley, Liza E. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Conley, Liza E. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7166918838

Connolly, Sara R. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Coolidge, Jonathan N. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Coolidge, Jonathan N. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Coolidge, Jonathan N. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Coolidge, Jonathan N. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Corcoran, Kevin J. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Corliss, Jennifer M. Emergency Medicine MedFirst Urgent Care PLLC 1715 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Corliss, Jennifer M. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7165801813

Corliss, Jennifer M. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Corliss, Jennifer M. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Cormier, Lee A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Cormier, Lee A. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Cornell, Waseya A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168282666

Cosgrove, Edward J. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Cosgrove, Edward J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Cosgrove, Edward J. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Covey, Andrew J. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Covey, Andrew J. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Covey, Andrew J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Covey, Andrew J. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Covey, Andrew J. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Page 32 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Covey, Andrew J. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Covey, Andrew J. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Covey, Andrew J. Emergency Medicine MFHS Physicians Emerg Svcs PC Dept 744 PO Box 8000 Buffalo NY 14267 Erie 7166910686

Covey, Andrew J. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Covey, Andrew J. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Dailey, Brian D. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Dailey, Brian D. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Dailey, Brian D. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Dailey, Brian D. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dailey, Brian D. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Daniel, Gregory F. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Daniel, Gregory F. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Daniel, Gregory F. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Daniel, Gregory F. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dara, Tanvir M. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7162044500

Dara, Tanvir M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Dara, Tanvir M. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Dara, Tanvir M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dara, Tanvir M. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Dara, Tanvir M. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Dara, Tanvir M. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Davis, John K. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Davis, John K. Emergency Medicine Exigence Medical of Hornell PLLC 6653 Main St Williamsville NY 14221 Erie 7162044500

Dayton, John R. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

DeFazio, Christian R. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169294613

DeFazio, Christian R. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

DeFazio, Christian R. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

DeFazio, Christian R. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

DeFazio, Christian R. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Diantonio, Michael C. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 142202039 Erie 7168267000

Diantonio, Michael C. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 142171304 Erie 7164476100

Diantonio, Michael C. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Diantonio, Michael C. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Diantonio, Michael C. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 142254097 Erie 7168912400

Dibella, Michael D. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168267000

Dibella, Michael D. Emergency Medicine Buffalo Emergency Associates 2950 Elmwwod Avenue Emergency Dept Kenmore NY 14217 Erie 7164476100

Dibella, Michael D. Emergency Medicine Buffalo Emergency Associates 2157 Main Street Emergency Dept Buffalo NY 14214 Erie 7168621000

Dibella, Michael D. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Ambulatory Care Orchard Park NY 14127 Erie 7166620500

Dibella, Michael D. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Dibella, Michael D. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Dice, William H. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983525

Dice, William H. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

DiFrancesco, Gregory C. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Dlugosz, Michael R. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Dlugosz, Michael R. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Dlugosz, Michael R. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Dlugosz, Michael R. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7168340700

Domondon Jr, Fernando B. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dowidowicz, Anthony J. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Dowidowicz, Anthony J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dowidowicz, Anthony J. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Dowidowicz, Anthony J. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Dowidowicz, Anthony J. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Doyle, Frances Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Dymott, Jean A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ebling, Nancy C. Emergency Medicine Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Ebling, Nancy C. Emergency Medicine Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7168983000

Ebling, Nancy C. Emergency Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7168172938

Ebling, Nancy C. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Ebling, Nancy C. Emergency Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Ebling, Nancy C. Emergency Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ebling, Nancy C. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Ellis, David G. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Ellis, David G. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ellis, David G. Emergency Medicine FDR Medical Services PC 462 Grider St Buffalo NY 14215 Erie 7168983525

Ellis, David G. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983525

Page 33 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Elman, Richard S. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Elman, Richard S. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Enriquez Jr, Santiago M. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 2018376644

Farber Heath, Risa Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Ferguson, Michael S. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Ferguson, Michael S. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Ferguson, Michael S. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Ferguson, Michael S. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Ferguson, Michael S. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Ferguson, Michael S. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Ferguson, Michael S. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Ferguson, Michael S. Emergency Medicine MFHS Physicians Emerg Svcs PC Dept 744 PO Box 8000 Buffalo NY 14267 Erie 7166910686

Ferguson, Michael S. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ferguson, Michael S. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Ferrando Ross, Pedro I. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Fields, Douglas W. Emergency Medicine Exigence Medical of Binghamton PLLC 1 John James Audubon Pkwy Amherst NY 14228 Erie 9048051010

Filice, Michael A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Fisher, Hope C. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Fisher, Mark D. Emergency Medicine Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7168983000

Fomitchev, Oleg V. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Franco, Leonard S. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Frazier, William J. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 8566864317

Freitas, Michael S. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Freitas, Michael S. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7165801815

Freitas, Michael S. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Freitas, Michael S. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Gadallah, Yousri E. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Gadallah, Yousri E. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gadallah, Yousri E. Emergency Medicine Buffalo Emergency Associates 2175 Main St Buffalo NY 14214 Erie 7168621000

Gadallah, Yousri E. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Gadallah, Yousri E. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Gasiewicz, Steve C. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Gasiewicz, Steve C. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Gelman, Leonard M. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Gelman, Leonard M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912415

Gelman, Leonard M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Gelman, Leonard M. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168332073

Gelman, Leonard M. Emergency Medicine Buffalo Emergency Associates 55 Melroy Ave Lackawanna NY 14218 Erie 7168258000

Gleeson, Carol Ann Emergency Medicine Exigence Medical of Binghamton PLLC 1 John James Audubon Pkwy Buffalo NY 14228 Erie 9048051010

Gorman, Gerald R. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Gorman, Gerald R. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Gorsline, Spencer H. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagra Falls Blvd Buffalo NY 14228 Erie 7166918838

Gorsline, Spencer H. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Buffalo NY 14226 Erie 7166918838

Gorsline, Spencer H. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Buffalo NY 14223 Erie 7166918838

Gorsline, Spencer H. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Buffalo NY 14217 Erie 7166918838

Gorsline, Spencer H. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7166918838

Gorsline, Spencer H. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7166918838

Grates Sciarrino, Alexis A. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7169292800

Grates Sciarrino, Alexis A. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7168447100

Grates Sciarrino, Alexis A. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7163628777

Grates Sciarrino, Alexis A. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7167998190

Grates Sciarrino, Alexis A. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167773391

Grates Sciarrino, Alexis A. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Grochowski, Sandra Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Grochowski, Sandra Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Grochowski, Sandra Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Grochowski, Sandra Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Grochowski, Sandra Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gutillo, Kathryn L. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Gutillo, Kathryn L. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Gutillo, Kathryn L. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Gutillo, Kathryn L. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168267000

Gutillo, Kathryn L. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Gutillo, Kathryn L. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Haen, Mark A. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7166918838

Haen, Mark A. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7166918838

Page 34 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Haen, Mark A. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Haen, Mark A. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7166918838

Haen, Mark A. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713283

Haen, Mark A. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Hamza, Mahmoud I. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Hashmi, Yahya J. Emergency Medicine Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7168983000

Hashmi, Yahya J. Emergency Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7168172938

Helman, Joshua B. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Hickox, Douglas J. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7162044500

Hickox, Douglas J. Emergency Medicine Exigence Medical of Binghamton PLLC 1 John James Autoban Buffalo NY 14228 Erie 7162044500

Hickox, Douglas J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hobika, Geoffrey G. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Hobika, Geoffrey G. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168332073

Hobika, Geoffrey G. Emergency Medicine Buffalo Emergency Associates 55 Melroy Lackawanna NY 14218 Erie 7168258000

Hobika, Geoffrey G. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hobika, Geoffrey G. Emergency Medicine Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912415

Hobika, Geoffrey G. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476596

Huffman, Darren M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168282666

Hughes, David P. Emergency Medicine MFHS Physicians Emerg Svcs PC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Hughes, David P. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Wililamsville NY 14221 Erie 7165686550

Hughes, David P. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Circle Buffalo NY 14209 Erie 7166918838

Hughes, David P. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Hughes, David P. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Humphrey, Alyssa N. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Ibrahim, Ameer F. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Ibrahim, Ameer F. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7165801815

Ibrahim, Ameer F. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165801815

Ibrahim, Ameer F. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Igoe, Gerald P. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168984430

Jackson Jr, Garland C. Emergency Medicine Exigence Medical of Binghamton PLLC 1 John James Audubon Pkwy Amherst NY 14228 Erie 9048051010

Jackson Jr, Garland C. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

James, David M. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

James, David M. Emergency Medicine MFHS Physicians Emerg Svcs PC 305 Cayuga Rd Ste 190 Cheektowaga NY 14225 Erie 7168878200

James, David M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

James, David M. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

James, David M. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

James, David M. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

James, David M. Emergency Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

James, David M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

James, David M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

James, David M. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Janicke, David M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Janicke, David M. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Janicke, David M. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Janicke, David M. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Janicke, David M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Janicke, David M. Emergency Medicine MedFirst Urgent Care PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Janicke, David M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Janicke, David M. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Janicke, David M. Emergency Medicine MedFirst Urgent Care PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Janik, Heather M. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Janik, Heather M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162044500

Jehle, Dietrich V. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Jehle, Dietrich V. Emergency Medicine University Emergency Medical Services 462 Grider St G242 Buffalo NY 14215 Erie 7168984430

Jin, Ken Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Joffe, Ralf Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Joffe, Ralf Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Johnson, Laura J. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Juette, Paul H. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Juette, Paul H. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Kanter, Marc P. Emergency Medicine Downtown Bronx Medical Associates 234 E 194th St East Amherst NY 14051 Erie 7185796021

Kaushal, Ashok Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Kaushal, Ashok Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168261000

Kaushal, Ashok Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Kaushal, Ashok Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kaushal, Ashok Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Page 35 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kaushal, Ashok Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Khan, Mateen A. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Khan, Mateen A. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Khan, Mateen A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168267000

Khan, Mateen A. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Khan, Mateen A. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Kilbury Taylor, Laurie L. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Klawitter, Paul F. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801813

Klein, Michael J. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Klein, Michael J. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Klein, Michael J. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Klein, Michael J. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Klein, Michael J. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Klein, Michael J. Emergency Medicine MedFirst Urgent Care PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Klein, Michael J. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Klein, Michael J. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Klein, Michael J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Koenig, Benjamin O. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Koenig, Benjamin O. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Koenig, Benjamin O. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Kopels, Morris Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Kopels, Morris Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Kopels, Morris Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Kopels, Morris Emergency Medicine Buffalo Emergency Associates 2950 Elwood Ave Buffalo NY 14217 Erie 7164476100

Kopels, Morris Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Kramer, Bree C. Emergency Medicine Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kratochvil, Matthew J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7169292800

Kratochvil, Matthew J. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7163628777

Kratochvil, Matthew J. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Kratochvil, Matthew J. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7167998190

Krause, Richard S. Emergency Medicine Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Krause, Richard S. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Krause, Richard S. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Krause, Richard S. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168984017

Krause, Richard S. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Krawczyk, Christian M. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168332073

Krawczyk, Christian M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Krawczyk, Christian M. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476596

Krawczyk, Christian M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912415

Krawczyk, Christian M. Emergency Medicine Buffalo Emergency Associates 55 Melroy Lackawanna NY 14218 Erie 7168258000

Kross, Jordan A. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Kross, Jordan A. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165801813

Kross, Jordan A. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Kross, Jordan A. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7165801813

Kundu, Renita Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kundu, Renita Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Kundu, Renita Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Kundu, Renita Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Kundu, Renita Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Kupper, Aric S. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Labinson, Robert M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

LaFountain, Richard B. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

LaFountain, Richard B. Emergency Medicine MedFirst Urgent Care PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

LaFountain, Richard B. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

LaFountain, Richard B. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Cir Buffalo NY 14209 Erie 7166918838

LaFountain, Richard B. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

LaFountain, Richard B. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

LaFountain, Richard B. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

LaFountain, Richard B. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

LaFountain, Richard B. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Lagaly, William J. Emergency Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Lakomy, Steven A. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Lakomy, Steven A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lakomy, Steven A. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Lakomy, Steven A. Emergency Medicine Buffalo Emergency Associates 55 Melroy Ave Lackawanna NY 14218 Erie 7168258000

Lakomy, Steven A. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Page 36 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lamothe, P Henri Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Lamothe, P Henri Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Lamothe, P Henri Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Lamothe, P Henri Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lamothe, P Henri Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Lamothe, P Henri Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Langan, Marsha B. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Buffalo NY 14221 Erie 7165686550

LeBlanc, Cherryll A. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

LeBlanc, Cherryll A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

LeBlanc, Cherryll A. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

LeBlanc, Cherryll A. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

LeBlanc, Cherryll A. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Lee, Frank M. Emergency Medicine St Joseph Hospital 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Lee, Frank M. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Lee, Frank M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Lee, Frank M. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Lee, Frank M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lee, Frank M. Emergency Medicine Buffalo Emergency Associates 55 Melroy Lackawanna NY 14218 Erie 7168258000

Lema, Penelope S. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7166918838

Lindroos, Chad M. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ljungberg, Alexander S. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Ljungberg, Alexander S. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7163628777

Ljungberg, Alexander S. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7169292800

Ljungberg, Alexander S. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7168447100

Ljungberg, Alexander S. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7167998190

Ljungberg, Alexander S. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Lopez, Daniel Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Lopez, Daniel Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lopez, Stephen Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Wililamsville NY 14221 Erie 7165686550

Lopez, Stephen Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Lopez, Stephen Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Lopez, Stephen Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Lopez, Stephen Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Luterman, Maynard Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Luterman, Maynard Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Lynch, Joshua J. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Lynch, Joshua J. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Byrant St Buffalo NY 14222 Erie 7169294613

Lynch, Joshua J. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Majeed, Mian A. Emergency Medicine Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Majeed, Mian A. Emergency Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Malinich, Thomas R. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Mandel, Adam H. Emergency Medicine ACS Emergency Physicians of SC PC 36 Crystal Tree Ct Buffalo NY 14224 Erie 8772484846

Manka Jr, Michael A. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983525

Manka Jr, Michael A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Manka Jr, Michael A. Emergency Medicine FDR Medical Services PC 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Manka Jr, Michael A. Emergency Medicine FDR Medical Services PC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Manteghi, Tara Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Manteghi, Tara Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Manteghi, Tara Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Manteghi, Tara Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Manteghi, Tara Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Martin, Michael P. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7169292800

Martin, Michael P. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Martin, Michael P. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7167999819

Martin, Michael P. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Martin, Michael P. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7163628777

Martin, Michael P. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7168447100

Martin, Raquel G. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Martin, Raquel G. Emergency Medicine Buffalo Emergency Associates 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Martin, Raquel G. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Mast, Dean E. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Mast, Dean E. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Mast, Dean E. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

McCormack, Robert F. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

McCormack, Robert F. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

McCormack, Robert F. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page 37 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

McGee, Kevin R. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

McGee, Kevin R. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

McGee, Kevin R. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

McGee, Kevin R. Emergency Medicine University Emergency Medical Services 462 Grinder St Buffalo NY 14215 Erie 7168983478

McGee, Kevin R. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

McGee, Kevin R. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Meyer, David J. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Meyer, David J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7168340700

Meyer, David J. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Michael, Lori A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Mineo, Michael J. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Mineo, Michael J. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Mineo, Michael J. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Mirshak, Monique Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Mirshak, Monique Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Mirshak, Monique Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Mirshak, Monique Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Mirshak, Monique Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Moscati, Ronald M. Emergency Medicine Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168588422

Moscati, Ronald M. Emergency Medicine Erie County Medical Center 1500 Broadway Buffalo NY 14212 Erie 7168917711

Moscati, Ronald M. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983525

Myers, Jeffrey W. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Myers, Jeffrey W. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Myers, Jeffrey W. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Myers, Jeffrey W. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Myers, Jeffrey W. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Cir Buffalo NY 14209 Erie 7166918838

Myers, Jeffrey W. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Neely, Cheryl L. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Neely, Cheryl L. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Neely, Cheryl L. Emergency Medicine Professional Emergency Services PLLC 3 Gates Circle Buffalo NY 14209 Erie 7166918838

Neely, Cheryl L. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Neely, Cheryl L. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Newman, Jay L. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Noor, Muhammad A. Emergency Medicine Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874493

Noor, Muhammad A. Emergency Medicine Inpatient Medical Services PLLC 100 High St Buffalo NY 14213 Erie 7168594234

Noor, Muhammad A. Emergency Medicine Inpatient Medical Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7168874798

Noor, Muhammad A. Emergency Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Noor, Muhammad A. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Notebaert, Danielle Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Olsen, Erica L. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14202 Erie 7166918838

Ostrum Jr, Arthur G. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ostrum Jr, Arthur G. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 8668987117

Ostrum Jr, Arthur G. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Ostrum Jr, Arthur G. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Owen, Ira D. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7166918838

Owen, Ira D. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Owen, Ira D. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7166918838

Owen, Ira D. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7166918838

Owen, Ira D. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Owen, Ira D. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7166918838

Pacheco, Kevin J. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983478

Padi, Abhilash R. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Parker, Brandon J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Patel, Ketan H. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 8668987117

Paul, Sucharita Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Paul, Sucharita Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Paul, Sucharita Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7166918838

Pawlowski, Jill M. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Perez Brache, Jose G. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Perez Brache, Jose G. Emergency Medicine MFHS Physicians Emerg Svcs PC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Perez Brache, Jose G. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Perry, Cheryl D. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168171912

Perry, Gregory C. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Perry, Jordan Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7165801813

Perry, Jordan Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Perry, Jordan Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Page 38 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Peterson, Erik P. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Peterson, Erik P. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Peterson, Erik P. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Peterson, Erik P. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Peterson, Erik P. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Petroski, Tara M. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Pfalzer, Aaron M. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Pfalzer, Aaron M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Pfalzer, Aaron M. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Pfalzer, Aaron M. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Pfalzer, Aaron M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Pfalzer, Aaron M. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Pfalzer, Aaron M. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Pfalzer, Aaron M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Pfalzer, Aaron M. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Pfalzer, Aaron M. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Pfalzer, Aaron M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Pfalzer, Aaron M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Pfalzer, Aaron M. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Pfalzer, Aaron M. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Piazza, Gina M. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Piazza, Gina M. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Pierce, David L. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Pierce, David L. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Pierce, David L. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Pierce, David L. Emergency Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591993

Pierce, David L. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Pierce, David L. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Pierce, David L. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Pierce, David L. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Pillai, Anita K. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Pillai, Anita K. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Podlas, Mark R. Emergency Medicine Kaleida Health 1595 Bailey Ave Buffalo NY 14212 Erie 7168938550

Podlas, Mark R. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Podlas, Mark R. Emergency Medicine Buffalo Emergency Associates 1595 Bailey Ave Buffalo NY 14212 Erie 7168938550

Podlas, Mark R. Emergency Medicine St Joseph Hospital 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Podlas, Mark R. Emergency Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621835

Podlas, Mark R. Emergency Medicine Kaleida Health 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Podlas, Mark R. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Ponkow Falvo, Sara J. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Ponkow Falvo, Sara J. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Ponkow Falvo, Sara J. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Ponkow Falvo, Sara J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ponkow Falvo, Sara J. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Ponkow Falvo, Sara J. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Poreda, Andrew R. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Poreda, Andrew R. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sherdian Dr Tonawanda NY 14223 Erie 7167016331

Poreda, Andrew R. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7165801813

Poreda, Andrew R. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Poreda, Andrew R. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Poreda, Andrew R. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Pozo, Milton L. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Pozo, Milton L. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Pozo, Milton L. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Pozo, Milton L. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Pozo, Milton L. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Prakash, Om Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7165801815

Prakash, Om Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Pugh, Jennifer L. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Pugh, Jennifer L. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801815

Pugh, Jennifer L. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Pundt, Mark R. Emergency Medicine MFHS Physicians Emerg Svcs PC 1540 Maple Road Williamsville NY 14221 Erie 7165918838

Pundt, Mark R. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Pundt, Mark R. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Pundt, Mark R. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Pundt, Mark R. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Page 39 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Pundt, Mark R. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Circle Buffalo NY 14209 Erie 7166918838

Pundt, Mark R. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Pundt, Mark R. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Pundt, Mark R. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Pundt, Mark R. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Radford, John C. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Radford, John C. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Radford, John C. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Radford, John C. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168984430

Radford, John C. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912450

Radford, John C. Emergency Medicine FDR Medical Services PC 462 Grider St Buffalo NY 14215 Erie 7168984430

Radford, John C. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Radford, John C. Emergency Medicine Buffalo Emergency Associates 462 Grider St Buffalo NY 14215 Erie 7168984430

Radford, John C. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Radford, John C. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Rainville, Michelle E. Emergency Medicine Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912415

Rainville, Michelle E. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476596

Rainville, Michelle E. Emergency Medicine Buffalo Emergency Associates 55 Melroy Lackawanna NY 14218 Erie 7168258000

Rainville, Michelle E. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rainville, Michelle E. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168332073

Reddy, Kaunteya Emergency Medicine Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7162044500

Reddy, Sivakumar A. Emergency Medicine Reddy Care Urgent Medical Center 6161 Transit Rd Ste 6 East Amherst NY 14051 Erie 7166886161

Reino, David L. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Reino, David L. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7168595600

Reischel, Ulrich A. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Reischel, Ulrich A. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168282666

Reischel, Ulrich A. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Reischel, Ulrich A. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Reischel, Ulrich A. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Reischel, Ulrich A. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Rich, Sara M. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7169292800

Rich, Sara M. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Rich, Sara M. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713283

Rich, Sara M. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7168340700

Rich, Sara M. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Rich, Sara M. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Riga, Peter J. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Rodriguez Betancourt, Luis F. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 2018376644

Rogers, Jennifer L. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Santillo, John R. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Mercy Hosp of Buffalo Emergency Dept Buffalo NY 14220 Erie 7168267000

Santillo, John R. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Mercy Ambulatory Orchard Park NY 14127 Erie 7166620500

Santillo, John R. Emergency Medicine Buffalo Emergency Associates 2157 Main St Sisters of Charity Hosp Emergency Dept Buffalo NY 14214 Erie 7168621000

Santillo, John R. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd St Joseph Hosp Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Santillo, John R. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore Mercy Hosp Emergency Dept Kenmore NY 14217 Erie 7164476100

Santillo, John R. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Sasse, Troy J. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Sasse, Troy J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Sasse, Troy J. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Sasse, Troy J. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Sasse, Troy J. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Schapiro, Ann E. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Schapiro, Ann E. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168282666

Schapiro, Ann E. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Schapiro, Ann E. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Schapiro, Ann E. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Scolnick, David Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 142254097 Erie 7168912400

Scolnick, David Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 142171304 Erie 7164476100

Scolnick, David Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Scolnick, David Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 9048051010

Scolnick, David Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Sebastian, Karen E. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Semashko, Denise C. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7169315595

Semashko, Denise C. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7169315595

Serra, David J. Emergency Medicine Buffalo-Niagara Hospitalists LLC 2950 Elmwood Ave Kenmore NY 142171304 Erie 7164476100

Serra, David J. Emergency Medicine David J Serra, MD 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Sharma, Rakesh Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 8668987117

Page 40 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Sieminski, Mark M. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Sieminski, Mark M. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7166918838

Sieminski, Mark M. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Sieminski, Mark M. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Sieminski, Mark M. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Sieminski, Mark M. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Silva, April A. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Slobodzian, John C. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623160

Soukup, Thomas V. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Soukup, Thomas V. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7169292800

Soukup, Thomas V. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Soukup, Thomas V. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Soukup, Thomas V. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7168340700

Soukup, Thomas V. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713283

Spavento, Perry J. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Spavento, Perry J. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Spavento, Perry J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Spavento, Perry J. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Spurgeon, Paul S. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Spurgeon, Paul S. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Spurgeon, Paul S. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Spurgeon, Paul S. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787109

Spurgeon, Paul S. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Stein, David Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Stein, David Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Stein, David Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Stein, David Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Stein, David Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Sterba, John A. Emergency Medicine Saved by Grace Ministry, Inc 226 Center Rd East Aurora NY 14052 Erie 7166556854

Stoughton, James E. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 8668987117

Strait, Paul S. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Strait, Paul S. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Strait, Paul S. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Strait, Paul S. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Strait, Paul S. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168282666

Strait, Paul S. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Suffoletto, Heidi Narins R. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Suffoletto, Heidi Narins R. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Suffoletto, Heidi Narins R. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Suffoletto, Heidi Narins R. Emergency Medicine MFHS Physicians Emerg Svcs PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Suffoletto, Heidi Narins R. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Suffoletto, Heidi Narins R. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Sullivan, Laurie E. Emergency Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7168172938

Sullivan, Ross W. Emergency Medicine Exigence Medical of Binghamton PLLC 1 John James Audubon Pkwy Amherst NY 14228 Erie 9048051010

Svoboda, Karl T. Emergency Medicine Exigence Medical of Binghamton PLLC 6653 Main St Buffalo NY 14221 Erie 9048051010

Takats III, Joseph R. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Tanski, Christopher T. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983478

Territo, Heather M. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Territo, Heather M. Emergency Medicine Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168587687

Territo, Heather M. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Teuscher, Josette A. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Teuscher, Josette A. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787109

Teuscher, Josette A. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Teuscher, Josette A. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Teuscher, Josette A. Emergency Medicine Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Teuscher, Josette A. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Thompson, Jeffrey J. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Thompson, Jeffrey J. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Thompson, Jeffrey J. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Thompson, Jeffrey J. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Thompson, Jeffrey J. Emergency Medicine Professional Emergency Services PLLC 3 Gates Circle Buffalo NY 14209 Erie 7166918838

Thompson, Jeffrey J. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Thompson, Jeffrey J. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Thompson, Jeffrey J. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Tinnesz, Michael D. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Tinnesz, Michael D. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Circle Buffalo NY 14209 Erie 7166918838

Page 41 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Tinnesz, Michael D. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Tinnesz, Michael D. Emergency Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Tinnesz, Michael D. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Tinnesz, Michael D. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Tinnesz, Michael D. Emergency Medicine Professional Emergency Services PLLC 3 Gates Circle Buffalo NY 14209 Erie 7166918838

Tinnesz, Michael D. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Wililamsville NY 14221 Erie 7165686550

Tinnesz, Michael D. Emergency Medicine MFHS Physicians Emerg Svcs PC 1540 Maple Road Williamsville NY 14221 Erie 7165918838

Tinnesz, Michael D. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Tinnesz, Michael D. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Tschernyavsky, Sylvia J. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Tschernyavsky, Sylvia J. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Tschernyavsky, Sylvia J. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Tschernyavsky, Sylvia J. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Tschernyavsky, Sylvia J. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Veland, Robert R. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7166918838

Veland, Robert R. Emergency Medicine MedFirst Urgent Care PLLC 3190 Niagara Falls Blvd Amherst NY 14228 Erie 7166918838

Veland, Robert R. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7166918838

Veland, Robert R. Emergency Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7168340700

Veland, Robert R. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Veland, Robert R. Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Walters, Brian M. Emergency Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Walters, Brian M. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Walters, Brian M. Emergency Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Walters, Brian M. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Walters, Brian M. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168282666

Walters, Brian M. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Watt, Courtenay C. Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Watt, Courtenay C. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162044500

Watt, Courtenay C. Emergency Medicine MFHS Physicians Emerg Svcs PC 3 Gates Cir Buffalo NY 14209 Erie 7166918838

Watt, Courtenay C. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7166918838

Watt, Courtenay C. Emergency Medicine MFHS Physicians Emerg Svcs PC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Watt, Courtenay C. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166918838

Watt, Courtenay C. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Werthman-Ehrenreich, Amanda Anne Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Werthman-Ehrenreich, Amanda Anne Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Werthman-Ehrenreich, Amanda Anne Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Werthman-Ehrenreich, Amanda Anne Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Werthman-Ehrenreich, Amanda Anne Emergency Medicine MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Werthman-Ehrenreich, Amanda Anne Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Werthman-Ehrenreich, Amanda Anne Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Westner, Thomas G. Emergency Medicine Buffalo Emergency Associates 2157 Main St Emergency Dept Buffalo NY 14214 Erie 7168621000

Westner, Thomas G. Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Westner, Thomas G. Emergency Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Westner, Thomas G. Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Westner, Thomas G. Emergency Medicine MFHS Physicians Emerg Svcs PC 1540 Maple Rd Williamsville NY 14221 Erie 7166883107

Westner, Thomas G. Emergency Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

Westner, Thomas G. Emergency Medicine Buffalo Emergency Associates 565 Abbott Rd Emergency Dept Buffalo NY 14220 Erie 7168267000

Wiech, Carolyn Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7168595600

Wiech, Carolyn Emergency Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Wiech, Carolyn Emergency Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165801813

Wiech, Carolyn Emergency Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7165801813

Wiech, Carolyn Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Wiech, Carolyn Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Wilson, Juliana E. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Wilson, Juliana E. Emergency Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983478

Wilson, Juliana E. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Wilson, Juliana E. Emergency Medicine MedFirst Urgent Care PLLC 1751 Sheridan Dr Tonawanda NY 14223 Erie 7167016331

Wilson, Juliana E. Emergency Medicine MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7167016331

Wilson, Juliana E. Emergency Medicine MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Wisiorek, Michael F. Emergency Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Wodowski, Stephanie A. Emergency Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Wodowski, Stephanie A. Emergency Medicine University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168783306

Wodowski, Stephanie A. Emergency Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Young, Gregory E. Emergency Medicine University Emergency Medical Services 100 High St Buffalo NY 14203 Erie 7165801802

Young, Gregory E. Emergency Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591993

Armenia, Joseph P. Endocrin,Diabetes & Meta Medical Associates Southtown PC 300 Center Rd Buffalo NY 14224 Erie 7166753754

Page 42 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Armenia, Joseph P. Endocrin,Diabetes & Meta Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Batra, Manav Endocrin,Diabetes & Meta Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Batra, Manav Endocrin,Diabetes & Meta Kaleida Health 100 High St Buffalo NY 14203 Erie 7166267970

Batra, Manav Endocrin,Diabetes & Meta Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Batra, Manav Endocrin,Diabetes & Meta Kaleida Health 115 Flint Rd Williamsville NY 14221 Erie 7166267970

Chaudhuri, Ajay Endocrin,Diabetes & Meta Academic Medicine Services 3 Gates Cir Buffalo NY 14209 Erie 7168874069

Cukierman, Jack Endocrin,Diabetes & Meta Cukierman, Jack 4247 Maple Rd Amherst NY 14226 Erie 7168359871

Cukierman, Jack Endocrin,Diabetes & Meta Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Dandona, Paresh Endocrin,Diabetes & Meta Kaleida Health 115 Flint Rd Williamsville NY 14221 Erie 7166267970

Dandona, Paresh Endocrin,Diabetes & Meta Kaleida Health 100 High St Buffalo NY 14203 Erie 7166267970

Dandona, Paresh Endocrin,Diabetes & Meta Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Frachetti, Katherine J. Endocrin,Diabetes & Meta Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Giardino, Karen F. Endocrin,Diabetes & Meta Giardino, Karen 5530 Sheridan Dr Ste 1B Williamsville NY 14221 Erie 7166361947

Haque, Shahid Endocrin,Diabetes & Meta Haque, Shahid 4247 Maple Rd Buffalo NY 14226 Erie 7168359871

Kuhadiya, Nitesh D. Endocrin,Diabetes & Meta Kaleida Health 115 Flint Rd Williamsville NY 14221 Erie 7166267970

Kuhadiya, Nitesh D. Endocrin,Diabetes & Meta Kaleida Health 100 High St Buffalo NY 14203 Erie 7166267970

Kuhadiya, Nitesh D. Endocrin,Diabetes & Meta Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983152

Kuhadiya, Nitesh D. Endocrin,Diabetes & Meta Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Lamantia, Robert S. Endocrin,Diabetes & Meta Lamantia, Robert 3911 Main St Eggertsville NY 14226 Erie 7168333366

Lamantia, Robert S. Endocrin,Diabetes & Meta Lamantia, Robert 3911 Main St Eggertsville NY 14226 Erie 7168333366

Lippes, Howard A. Endocrin,Diabetes & Meta Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Lippes, Howard A. Endocrin,Diabetes & Meta Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Lippes, Howard A. Endocrin,Diabetes & Meta R & B Medical Group Llp 297 Spindrift Dr Ste 200 Williamsville NY 14221 Erie 7166350688

Makdissi, Antoine Endocrin,Diabetes & Meta Kaleida Health 115 Flint Rd Williamsville NY 14221 Erie 7166267970

Makdissi, Antoine Endocrin,Diabetes & Meta Kaleida Health 100 High St Buffalo NY 14203 Erie 7166267970

Makdissi, Antoine Endocrin,Diabetes & Meta Academic Medicine Services 3 Gates Cir Buffalo NY 14209 Erie 7168874069

Mersereau, Margaret R. Endocrin,Diabetes & Meta Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Murphy, Toni M. Endocrin,Diabetes & Meta Buffalo Endocrinology LLC 600 Harlem Rd West Seneca NY 14224 Erie 7163322121

Muzzammil, Ahmad Endocrin,Diabetes & Meta Muzzammil, Ahmad 539 Cleveland Dr Ste 100 Buffalo NY 14225 Erie 7169391188

Muzzammil, Ahmad Endocrin,Diabetes & Meta St Joseph Hospital 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Muzzammil, Ahmad Endocrin,Diabetes & Meta Muzzammil, Ahmad 3884 Broadway Cheektowaga NY 14227 Erie 7166900012

O'Donnell, Amy L. Endocrin,Diabetes & Meta VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Quijada, Norma C. Endocrin,Diabetes & Meta Norma Quijada Md 200 Sterling Dr Ste 400 Orchard Park NY 14127 Erie 7166770250

Quijada, Norma C. Endocrin,Diabetes & Meta Hamburg Nurse Practitioners in Adult Care 4535 Southwestern Blvd Ste 705 Hamburg NY 14075 Erie 7166483300

Ryan Jr, Augustine J. Endocrin,Diabetes & Meta Academic Medicine Services 4511 Harlem Buffalo NY 14215 Erie 7169614662

Ryan Jr, Augustine J. Endocrin,Diabetes & Meta Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983155

Ryan Jr, Augustine J. Endocrin,Diabetes & Meta Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168985065

Ryan Jr, Augustine J. Endocrin,Diabetes & Meta Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Sinha, Ravi N. Endocrin,Diabetes & Meta Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578770

Sinha, Ravi N. Endocrin,Diabetes & Meta Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Torre, Joseph J. Endocrin,Diabetes & Meta Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578620

Wnek, Amy L. Endocrin,Diabetes & Meta Southwestern Medical Associates 3675 Southwestern Blvd Orchard Park NY 14127 Erie 7169720279

Xarli, Vasiliki P. Endocrin,Diabetes & Meta Xarli, Vasiliki 3600 Seneca St West Seneca NY 14224 Erie 7166740726

Adamson, Jennifer J. Family Medicine Niagara Falls Memorial Medical Center 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167736181

Addesa Jr, Albert J. Family Medicine Associated Physicians Of Western New York Pc 2805 Wehrle Dr Ste 10 Williamsville NY 14221 Erie 7166835252

Ahuja, Sanjeev Family Medicine Alden Medical Group 12845 Broadway Alden NY 14004 Erie 7169373255

Alvarez, C Adriana Family Medicine R & B Medical Group Llp 297 Spindrift Dr Ste 200 Williamsville NY 14221 Erie 7166350688

Arora, Satish K. Family Medicine Sarita Kansal Md 725 Orchard Pk Rd West Seneca NY 14224 Erie 7166740101

Arora, Satish K. Family Medicine Arora, Satish 2095 Kensington Ave Snyder NY 14226 Erie 7168933755

Arora, Satish K. Family Medicine Arora, Satish 3768 Seneca St West Seneca NY 14224 Erie 7166753111

Baez, Maritza Y. Family Medicine Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Bodkin II, John J. Family Medicine Highgate Medical Group 1150 Youngs Rd Ste 104 Williamsville NY 14221 Erie 7166367979

Burke, Amy J. Family Medicine Amy J. Burke MD 3065 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7163623909

Burke, Amy J. Family Medicine Burke, Amy J. 565 Abbott Rd Buffalo NY 14220 Erie 7166552690

Burke, Amy J. Family Medicine Amy J. Burke MD 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Burnett, Jeffrey Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166683000

Caparaso, Darren M. Family Medicine Buffalo Medical Group 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7166564807

Caparaso, Darren M. Family Medicine Jennifer Erickson DO & Robert Erickson D 3671 Southwestern Blvd Ste 213 Orchard Park NY 14127 Erie 7166627008

Casey, Martin A. Family Medicine Casey, Martin 290 Center Rd West Seneca NY 14224 Erie 7166757693

Cavalieri, Morris M. Family Medicine Lakeshore Family Med Assoc PC 10626 Main St North Collins NY 14111 Erie 7163372422

Cavalieri, Morris M. Family Medicine Lakeshore Family Med Assoc PC 7060 Erie Rd Ste 100 Derby NY 14047 Erie 7169470408

Chima, Mary N. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166683000

Clifford, David S. Family Medicine Clifford, David 256 Center Rd West Seneca NY 14224 Erie 7166774159

Corigliano, Joseph F. Family Medicine Buffalo Medical Group 325 Essjay Rd Ste 110 Williamsville NY 14221 Erie 7166301465

Cotton, Shawn E. Family Medicine East Aurora Family Practice 112 Olean Rd Ste 220 East Aurora NY 14052 Erie 7168051072

Cruz, Jesenia Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Page 43 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Darling, Scott R. Family Medicine Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874493

Darling, Scott R. Family Medicine Scott Darling 2950 Elmwood Ave Kenmore Mercy Hospital Kenmore NY 14217 Erie 7164476100

Darling, Scott R. Family Medicine University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Darling, Scott R. Family Medicine Inpatient Medical Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7168874798

Darling, Scott R. Family Medicine University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 Orchard Park NY 14127 Erie 7168292070

Darling, Scott R. Family Medicine University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7162043200

Darling, Scott R. Family Medicine University Orthopaedics Services Inc 200 Sterling Ste 400 Orchard Park NY 14127 Erie 7166778410

Darling, Scott R. Family Medicine Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Darling, Scott R. Family Medicine Inpatient Medical Services PLLC 100 High St Buffalo NY 14213 Erie 7168594234

Darling, Scott R. Family Medicine University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Darling, Scott R. Family Medicine Scott R Darling MD PLLC 2950 Elmwood Ave Kenmore Mercy Hospital Kenmore NY 14217 Erie 7164476100

Degrave, Thomas E. Family Medicine Orchard Park Family Practice 3680 Eggert Rd Orchard Park NY 14127 Erie 7166625357

Erickson, Jennifer N. Family Medicine Jennifer Erickson DO & Robert Erickson D 3671 Southwestern Blvd Ste 213 Orchard Park NY 14127 Erie 7166627008

Erickson, Robert J. Family Medicine Jennifer Erickson DO & Robert Erickson D 3671 Southwestern Blvd Ste 213 Orchard Park NY 14127 Erie 7166627008

Evans, Stephen J. Family Medicine Elder Medical Services PC 34 Benwood Ave Buffalo NY 14214 Erie 7168622501

Evans, Stephen J. Family Medicine Elder Medical Services PC 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Evans, Stephen J. Family Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7169616995

Evans, Stephen J. Family Medicine Elder Medical Services PC 147 Reist Williamsville NY 14221 Erie 7166335400

Evans, Stephen J. Family Medicine IPC Hospitalist Services of New York, PC 50 Lakefront Blvd Ste 130 Buffalo NY 14202 Erie 7168498750

Evans, Stephen J. Family Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Evans, Stephen J. Family Medicine Elder Medical Services PC 2157 Main St Buffalo NY 14214 Erie 7168621450

Evans, Stephen J. Family Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Buffalo NY 14225 Erie 7162049711

Evans, Stephen J. Family Medicine Elder Medical Services PC 291 W North St Buffalo NY 14201 Erie 7168812323

Evans, Stephen J. Family Medicine Elder Medical Services PC 1503 Military Rd Buffalo NY 14217 Erie 7164476600

Fasanello, Joseph F. Family Medicine Highgate Medical Group 3950 E Robinson Rd Ste 207 West Amherst NY 14228 Erie 7165641111

Felstead, R Keith Family Medicine Primary Care of WNY LLP 30 N Union Rd Buffalo NY 14221 Erie 7168398000

Felstead, R Keith Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Fininzio, Cara M. Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Fininzio, Cara M. Family Medicine Primary Care of WNY LLP 30 N Union Rd Buffalo NY 14221 Erie 7168398000

Golding, Douglas J. Family Medicine Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166683600

Golding, Douglas J. Family Medicine Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Golding, Douglas J. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Golding, Douglas J. Family Medicine Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Halsdorfer, Andrew W. Family Medicine Buffalo Medical Group 325 Essjay Rd Ste 110 Williamsville NY 14221 Erie 7166301465

Harbison, Andrew J. Family Medicine Primary Care of WNY LLP 30 N Union Rd Williamsville NY 14221 Erie 7168398000

Harbison, Andrew J. Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Hatton, Elizabeth R. Family Medicine Hatton, Elizabeth 646 N French Rd Ste 3 Buffalo NY 14228 Erie 7166919365

Heim, Jacqueline M. Family Medicine Associated Physicians Of Western New York Pc 1616 Kensington Ave Buffalo NY 14215 Erie 7168353097

Heim, Jacqueline M. Family Medicine Associated Physicians Of Western New York Pc 2805 Wehrle Dr Ste 10 Williamsville NY 14221 Erie 7166835252

Henderson, Jennifer G. Family Medicine Kenmore Family Medicine Llp 2914 Elmwood Ave Kenmore NY 14217 Erie 7168756700

Hendricks, Orville I. Family Medicine Parkview Primary Care Physicians 20 Losson Rd Ste 105 Buffalo NY 14227 Erie 7165587727

Herman, Steven P. Family Medicine Herman, Steven 5893 Camp Rd Ste 4 Hamburg NY 14075 Erie 7166497722

Hughes III, Thomas F. Family Medicine Divan, Nita 1150 Youngs Rd Ste 203 Williamsville NY 14221 Erie 7166887344

Hughes III, Thomas F. Family Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592900

Ilozue, Frances E. Family Medicine Rapha Family Medicine Pc 2200 Main St Buffalo NY 14214 Erie 7162004122

Ilozue, Frances E. Family Medicine Rapha Family Medicine Pc 3610 Main St Amherst NY 14226 Erie 7168334019

Jordan, Michael R. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Kane, Michael P. Family Medicine Lakeshore Primary Care Associates LLP 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166461084

Karam Bayoumi, Rania A. Family Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166944500

Karam Bayoumi, Rania A. Family Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Karam Bayoumi, Rania A. Family Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7166944500

Karam Bayoumi, Rania A. Family Medicine Mercy Hospital 227 Ridge Rd Lackawanna NY 14218 Erie 7168225944

Kavcic, John M. Family Medicine Parkview Primary Care Physicians 20 Losson Rd Ste 105 Buffalo NY 14227 Erie 7165587727

Khawar, Semira K. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Amherst NY 14226 Erie 7166890040

Klementowski, Marc K. Family Medicine Buffalo Emergency Associates 6653 Main St Williamsville NY 14221 Erie 7162044500

Kodial, Sukhwinder S. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Kolbert, Mary K. Family Medicine Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Kolbert, Mary K. Family Medicine Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Kolbert, Mary K. Family Medicine Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166683600

Kolbert, Mary K. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Amherst NY 14226 Erie 7166890040

Koleini, Jahangir Family Medicine Koleini, Jahangir 3457 Clinton St West Seneca NY 14224 Erie 7166688226

Kowalski, David P. Family Medicine David P Kowalski MD PLLC 3065 Southwestern Blvd Ste 104 Orchard Park NY 14127 Erie 7166773065

Kuehnling, William R. Family Medicine Lancaster Medical LLC 4893 Transit Rd Depew NY 14043 Erie 7166087040

Kyger, Elizabeth L. Family Medicine Buffalo Geriatric & Rehabilitation Med 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Kyger, Elizabeth L. Family Medicine Buffalo Geriatric & Rehabilitation Med 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

LaDuca, Robert L. Family Medicine Robert L LaDuca MD 3671 Southwestern Blvd Orchard Park NY 14127 Erie 7166622595

Page 44 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lane, Darla M. Family Medicine Primary Care of WNY LLP 30 N Union Rd Buffalo NY 14221 Erie 7168398000

Lane, Darla M. Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Buffalo NY 14217 Erie 7168398000

Lawton, David A. Family Medicine East Aurora Family Practice 112 Olean Rd Ste 220 East Aurora NY 14052 Erie 7168051072

Leilabadi, Shahriyar A. Family Medicine Family Care Medicine PC 1208 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168332200

Lin Fu, Gracie M. Family Medicine Cheng Shung Fu Md Pc 6636 Main St Ste 1 Williamsville NY 14221 Erie 7166330541

MacLean, Craig K. Family Medicine Southtowns Family Practice PC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166466700

Mafi, Esfandiar Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Martinke, David J. Family Medicine Primary Care of WNY LLP 30 N Union Rd Williamsville NY 14221 Erie 7168398000

Martinke, David J. Family Medicine Primary Care of WNY LLP 2780 DELAWARE AVE Kenmore NY 14217 Erie 7168398000

Matala Sullivan, Maria E. Family Medicine Lakeshore Primary Care Associates LLP 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166461084

Matier, Jennifer M. Family Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Matthews, James H. Family Medicine Mercy Hospital 227 Ridge Rd Lackawanna NY 14218 Erie 7168225944

McCune, Leroy W. Family Medicine Buffalo Geriatric & Rehabilitation Med 6400 Powers Rd Orchard Park NY 14127 Erie 7166670001

McCune, Leroy W. Family Medicine Buffalo Geriatric & Rehabilitation Med 1 Fox Run Ln Orchard Park NY 14127 Erie 7165082150

McCune, Leroy W. Family Medicine Buffalo Geriatric & Rehabilitation Med S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

McCune, Leroy W. Family Medicine Buffalo Geriatric & Rehabilitation Med 2875 Union Rd Buffalo NY 14227 Erie 7166510911

McEntee, James J. Family Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7168282434

McMahon, Kevin C. Family Medicine East Aurora Family Practice 112 Olean Rd Ste 220 East Aurora NY 14052 Erie 7168051072

Mendonza, Lisa M. Family Medicine Kenmore Family Medicine Llp 2914 Elmwood Ave Kenmore NY 14217 Erie 7168756700

Murak, Daniel J. Family Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Murphy, Timothy G. Family Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282898

Novelli, David J. Family Medicine Novelli, David 260 Center Rd Wimbledon Walk In Care West Seneca NY 14224 Erie 7166774178

Novelli, David J. Family Medicine Novelli, David 256 Center Rd West Seneca NY 14224 Erie 7166774178

O Donnell, Patricia A. Family Medicine R & B Medical Group Llp 297 Spindrift Dr Ste 200 Williamsville NY 14221 Erie 7166350688

Ogorchock-Congilosi, Jessica E. Family Medicine Lakeshore Primary Care Associates LLP 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166461084

Oo, Geemson Family Medicine Geemson Oo MD PLLC 3775 Seneca St West Seneca NY 14224 Erie 7167120920

Padmanabha, Bhavansa Family Medicine Padmanabha, Bhavansa 2950 Elmwood Ave Room 5022 Buffalo NY 14217 Erie 7164476629

Padmanabha, Bhavansa Family Medicine Padmanabha, Bhavansa 63 Main St Akron NY 14001 Erie 7165422754

Palumbo, Vito D. Family Medicine Family Care Physicians 61 Maple Rd Williamsville NY 14221 Erie 7165651234

Panzarella, James J. Family Medicine Family Care Medicine PC 1208 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168332200

Pawlowski, David A. Family Medicine Highgate Medical Group 3950 E Robinson Rd West Amherst NY 14228 Erie 7165641111

Pfalzer, David F. Family Medicine Kenmore Family Medicine Llp 2914 Elmwood Ave Kenmore NY 14217 Erie 7168756700

Pusatier, Michael F. Family Medicine Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301131

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 580 Orchard Pk Rd Buffalo NY 14224 Erie 7166774242

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 815 Hopkins Rd Williamsville NY 14221 Erie 7166880111

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 4459 Bailey Ave Amherst NY 14226 Erie 7168352543

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 200 Bassett Rd Williamsville NY 14221 Erie 7166896681

Rahman, Qamrunnisa Family Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 14225 Erie 7162049711

Rahman, Qamrunnisa Family Medicine Kenmore Mercy Hospital 300 Two Mile Crk Rd Tonawanda NY 14150 Erie 7164476450

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 76 Buffalo St Hamburg NY 14075 Erie 7166497676

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 225 Bennett Rd Cheektowaga NY 14227 Erie 7166819480

Rahman, Qamrunnisa Family Medicine Elder Medical Services PC 5775 Maelou Dr Hamburg NY 14075 Erie 7166482820

Ram, Raghu Family Medicine Primary Care of WNY LLP 30 N Union Rd Williamsville NY 14221 Erie 7168398000

Ram, Raghu Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Reilly, Eileen B. Family Medicine Elder Medical Services PC 292 Main St East Aurora NY 14052 Erie 7166521560

Reilly, Eileen B. Family Medicine Buffalo Geriatric & Rehabilitation Med 1026 Union Rd West Seneca NY 14224 Erie 7167121030

Reilly, Eileen B. Family Medicine Elder Medical Services PC 1503 Military Rd Kenmore NY 14217 Erie 7164476600

Reilly, Eileen B. Family Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Cheektowaga NY 14225 Erie 7162049711

Reilly, Eileen B. Family Medicine Buffalo Geriatric & Rehabilitation Med One Fox Run Ln Orchard Park NY 14127 Erie 7166622150

Reilly, Eileen B. Family Medicine Buffalo Geriatric & Rehabilitation Med S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Riccione, Joseph A. Family Medicine Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564832

Robillard, Kristen M. Family Medicine Lakeshore Primary Care Associates LLP 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166461084

Roche, Bertrand P. Family Medicine Family Care Physicians 61 Maple Rd Williamsville NY 14221 Erie 7165651234

Roche, Robert R. Family Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Ruh, Richard J. Family Medicine Orchard Park Family Practice 3680 Eggert Rd Orchard Park NY 14127 Erie 7166625357

Rykert Wolf, Mary A. Family Medicine Lakeshore Family Med Assoc PC 7060 Erie Rd Ste 100 Derby NY 14047 Erie 7169470408

Rykert Wolf, Mary A. Family Medicine Lakeshore Family Med Assoc PC 10626 Main St North Collins NY 14111 Erie 7163372422

Sauret, John Family Medicine Kaleida Health 300 Niagara St Buffalo NY 14201 Erie 7168594110

Schueler, William C. Family Medicine Primary Care of WNY LLP 30 N Union Rd Buffalo NY 14221 Erie 7168398000

Schueler, William C. Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Buffalo NY 14217 Erie 7168398000

Sheikh, Henna M. Family Medicine Lakeshore Family Med Assoc PC 7060 Erie Rd Ste 100 Derby NY 14047 Erie 7169470408

Sheikh, Tariq A. Family Medicine Lakeshore Family Med Assoc PC 10626 Main St North Collins NY 14111 Erie 7163372422

Silverstein, David A. Family Medicine Elder Medical Services PC 2914 Elmwood Ave Kenmore NY 14217 Erie 7168756700

Silverstein, David A. Family Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Silverstein, David A. Family Medicine Kenmore Family Medicine Llp 2914 Elmwood Ave Kenmore NY 14217 Erie 7168756700

Silverstein, David A. Family Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Ste 1C Cheektowaga NY 14225 Erie 7162049711

Page 45 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Spillman, Sarah H. Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Stephan III, William H. Family Medicine Michael K Landi MD dba Brain and Spine Medical Services 4080 Delaware Ave Tonawanda NY 14150 Erie 7168757399

Stephan III, William H. Family Medicine Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Stephan III, William H. Family Medicine Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Stone, Steven S. Family Medicine Amherst Medical Associates LLP 6000 N Bailey Ave Ste 1d Amherst NY 14226 Erie 7168344266

Streicher, Jamie F. Family Medicine Sheridan Medical Group LLP 1491 Sheridan Dr Ste 100 Tonawanda NY 14217 Erie 7163324476

Swetz, Mark E. Family Medicine Swetz, Mark 3065 Southwestern Blvd Ste 206 Orchard Park NY 14127 Erie 7166741414

Szymanski, Chad E. Family Medicine Primary Care of WNY LLP 30 N Union Rd Williamsville NY 14221 Erie 7168398000

Teeter, Jennifer M. Family Medicine Kenmore Mercy Hospital 400 International Dr Williamsville NY 14221 Erie 7166348266

Thangathurai, Diana V. Family Medicine Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Thomas, Julie A. Family Medicine Orchard Park Family Practice 3680 Eggert Rd Orchard Park NY 14127 Erie 7166625357

Tota Thurn, Catherine Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Tota Thurn, Catherine Family Medicine Primary Care of WNY LLP 30 N Union Rd Williamsville NY 14221 Erie 7168398000

Trock, Daniel Family Medicine Highgate Medical Group 1150 Youngs Rd Ste 104 Williamsville NY 14221 Erie 7166367979

Tyler, Chad P. Family Medicine Sheridan Medical Group LLP 1491 Sheridan Dr Ste 100 Tonawanda NY 14217 Erie 7163324476

Usen, Joshua M. Family Medicine Sweet Home Family Medicine PC 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 7166367800

Vakante Jankovic, Diana Family Medicine Southwestern Medical Associates 3675 Southwestern Blvd Orchard Park NY 14127 Erie 7169720279

Vastola, Cary F. Family Medicine Primary Care of WNY LLP 2780 Delaware Ave Kenmore NY 14217 Erie 7168398000

Vastola, Cary F. Family Medicine Primary Care of WNY LLP 30 N Union Rd Williamsville NY 14221 Erie 7168398000

Vastola, Cary F. Family Medicine Primary Care of WNY LLP 2914 Elmwood Ave Ste 2 Kenmore NY 14217 Erie 7168398000

Wands, Ann M. Family Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Ward, John P. Family Medicine Ward, John 7531 Seneca St East Aurora NY 14052 Erie 7166555019

Weber, Ryan W. Family Medicine Buffalo-Niagara Hospitalists LLC 2950 Elmwood Ave Kenmore NY 142171304 Erie 7164476100

Weber, Ryan W. Family Medicine Weber, Ryan 9900 Main St Clarence NY 14031 Erie 7167598811

Weber, Ryan W. Family Medicine Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Weingarten, Elizabeth A. Family Medicine East Aurora Family Practice 112 Olean Rd Ste 220 East Aurora NY 14052 Erie 7168051072

Wisnoski, Jennifer A. Family Medicine Family Care Physicians 61 Maple Rd Williamsville NY 14221 Erie 7165651234

Witmer, Elvin D. Family Medicine Witmer, Elvin 565 Abbott Rd Buffalo NY 14220 Erie 7169127759

Witmer, Elvin D. Family Medicine Witmer, Elvin 76 Buffalo St Hamburg NY 14075 Erie 7166497676

Yates, Charles W. Family Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7168172938

Yates, Charles W. Family Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Cheektowaga NY 14225 Erie 7162049711

Yates, Charles W. Family Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 14225 Erie 7162049711

Joseph, Brian Forensic Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Lynch, Michael J. Forensic Psychiatry Lynch, Michael 1275 Delaware Ave Ste 403 Buffalo NY 14209 Erie 7168864644

Bain, Andrew J. Gastroenterology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Bartolone, Christopher J. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Bloom, Peter D. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Bou Abdallah, Jad Z. Gastroenterology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Burkard, Paula G. Gastroenterology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983391

Burkard, Paula G. Gastroenterology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Corasanti, James G. Gastroenterology Buffalo Niagara Gastroenterology PLLC 5225 Sheridan Dr Williamsville NY 14221 Erie 7166774414

Corasanti, James G. Gastroenterology 260 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7166774414

Diaz Ordaz, Albert J. Gastroenterology Southtowns Gastroenterology, PLLC 3065 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166779220

Eckert, Ronald J. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Eckert, Ronald J. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Fayyaz, Mohammad Gastroenterology Amherst Ob/Gyn Associates PC 130 Empire Dr West Seneca NY 14224 Erie 7166689765

Fayyaz, Mohammad Gastroenterology Buffalo Medical Group 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7166312517

Fayyaz, Mohammad Gastroenterology General Physician PC 210 E Main St Springville NY 14141 Erie 7162130025

Fayyaz, Mohammad Gastroenterology Buffalo Medical Group 9 Limestone Dr Williamsville NY 14221 Erie 7166312517

Fayyaz, Mohammad Gastroenterology Buffalo Medical Group 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166312517

Fayyaz, Mohammad Gastroenterology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Gaines, Katherine C. Gastroenterology Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Gaines, Katherine C. Gastroenterology Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Gaines, Katherine C. Gastroenterology Palliative Care Physicians Group PLLC 150 Bennett Rd Buffalo NY 14227 Erie 7166868460

Gaines, Katherine C. Gastroenterology Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Gaines, Katherine C. Gastroenterology Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Gaines, Katherine C. Gastroenterology Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Gaines, Katherine C. Gastroenterology Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Garson, David S. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Gupta, Alok D. Gastroenterology General Physician PC 210 East Main Street Springville NY 14141 Erie 7166923302

Gupta, Alok D. Gastroenterology Buffalo Medical Group 9 Limestone Dr Williamsville NY 14221 Erie 7166312517

Gupta, Alok D. Gastroenterology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166312577

Huang, Jonathan C. Gastroenterology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Kaplan, Richard D. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Kazbay, Kasim Gastroenterology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Kozower, Michael Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Page 46 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kroll, Megan M. Gastroenterology Buffalo Niagara Gastroenterology PLLC 5225 Sheridan Dr Williamsville NY 14221 Erie 7166262644

Kroll, Megan M. Gastroenterology Buffalo Niagara Gastroenterology PLLC 100 High St Buffalo NY 14203 Erie 7168595600

Luther, Ramesh Gastroenterology Digestive Health Physicians Pc 12845 Broadway Alden NY 14004 Erie 7168954400

Luther, Ramesh Gastroenterology Digestive Health Physicians Pc 2625 Harlem Rd Ste 240 Cheektowaga NY 14225 Erie 7168954400

Maheshwari, Yogesh Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Ste 1 Williamsville NY 14221 Erie 7166265250

Mahl, Thomas C. Gastroenterology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Mahl, Thomas C. Gastroenterology Academic Medicine Services 3495 Bailey Ave Buffalo NY 14215 Erie 7168623145

Mahl, Thomas C. Gastroenterology VA Western NY Health Med Ctr 899 Main St Buffalo NY 14203 Erie 7168826544

Mannone, Antonino Gastroenterology Main Gastroenterology PC 8201 Main St Ste 4 Williamsville NY 14221 Erie 7166323577

Mehboob, Shahid Gastroenterology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Mehboob, Shahid Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Ste 1 Williamsville NY 14221 Erie 7166265250

Mian, Naima A. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Miqdadi, Jehad A. Gastroenterology Buffalo Medical Group 2741 Transit Rd Elma NY 14059 Erie 7166776060

Miqdadi, Jehad A. Gastroenterology Buffalo Medical Group 9 Limestone Dr Williamsville NY 14221 Erie 7166312517

Miqdadi, Jehad A. Gastroenterology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166312517

Miqdadi, Jehad A. Gastroenterology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Moore, Michael C. Gastroenterology Moore, Michael 2943 Seneca St West Seneca NY 14224 Erie 7168253601

Novak, Jan M. Gastroenterology Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7168826544

Novak, Jan M. Gastroenterology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Pietrak, Stanley J. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Pietrak, Stanley J. Gastroenterology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Piscatelli, James J. Gastroenterology Buffalo Medical Group 9 Limestone Dr Williamsville NY 14221 Erie 7166312517

Pomakov, Ognian A. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Pomakov, Ognian A. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Rani, Abha Gastroenterology Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Rani, Abha Gastroenterology Digestive Health Physicians Pc 2625 Harlem Rd Ste 240 Cheektowaga NY 14225 Erie 7168954400

Rani, Abha Gastroenterology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Rani, Abha Gastroenterology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Rani, Abha Gastroenterology Academic Medicine Services 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Robillard, Kevin T. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Robillard, Kevin T. Gastroenterology Buffalo Gastroenterology Associates Llp 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166776501

Robillard, Kevin T. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Schaus, Benjamin J. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Schaus, Benjamin J. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Schiff, Michael D. Gastroenterology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Sette Camara, Daniel D. Gastroenterology Digestive Health Physicians Pc 2625 Harlem Rd Ste 240 Cheektowaga NY 14225 Erie 7168954400

Shah, Siddhartha S. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Singh, Amanpal Gastroenterology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Sitrin, Michael D. Gastroenterology VA Western NY Health Med Ctr 899 Main St Buffalo NY 14203 Erie 7168826544

Sitrin, Michael D. Gastroenterology Academic Medicine Services 3980 Sheridan Dr Buffalo NY 14226 Erie 7168826544

Sitrin, Michael D. Gastroenterology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Sitrin, Michael D. Gastroenterology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7169619900

Sitrin, Michael D. Gastroenterology Academic Medicine Services 4511 Harlem Buffalo NY 14215 Erie 7169614662

Sitrin, Michael D. Gastroenterology VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7166919900

Sohal, Kunwardeep S. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Sohal, Kunwardeep S. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

St Marie, Mark S. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

St Marie, Mark S. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Talal, Andrew H. Gastroenterology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Talal, Andrew H. Gastroenterology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Talal, Andrew H. Gastroenterology Kaleida Health 100 High St D-Bldg Ground Fl Buffalo NY 14203 Erie 7168592175

Trubish, Dorothy Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Trubish, Dorothy Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Tuoti, Raymond J. Gastroenterology Gastroenterology Associates LLP 60 Maple Rd Williamsville NY 14221 Erie 7166265250

Wacker, Timothy R. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Orchard Park NY 14127 Erie 7166776501

Wacker, Timothy R. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Weinrieb, Ilja J. Gastroenterology Ilja J Weinrieb Md Pc 1150 Youngs Rd Ste 205 Williamsville NY 14221 Erie 7166369056

Wells Jr, Theodore V. Gastroenterology Wells Gastroenterology LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120852

Wells Jr, Theodore V. Gastroenterology Wells Gastroenterology LLP 6000 N Bailey Ave Amherst NY 14226 Erie 7168346152

Wells Jr, Theodore V. Gastroenterology Wells Gastroenterology LLP 560 Franklin St Buffalo NY 14202 Erie 7168346152

Wood, Michael W. Gastroenterology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Wood, Michael W. Gastroenterology Buffalo Gastroenterology Associates Llp 260 Redtail Rd Orchard Park NY 14127 Erie 7166776501

Korff, Kathryn C. General Dentistry Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Lall, Shashi General Practice Lall, Shashi 8504 N Main St Eden NY 14057 Erie 7169923230

Lall, Shashi General Practice Lall, Shashi 725 Orchard Park Rd Orchard Ridge Med Ctr Ste A West Seneca NY 14224 Erie 7166751001

Lieber, Kent A. General Practice Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166944500

Page 47 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lieber, Kent A. General Practice Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7166944500

Lieber, Kent A. General Practice Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Lieber, Kent A. General Practice Kent A Lieber Md 565 Abbott Rd Mercy Hospital Buffalo NY 14220 Erie 7168646842

Luther, Prama General Practice Luther, Prama 2671 Harlem Rd Cheektowaga NY 14225 Erie 7168945610

Luther, Prama General Practice Luther, Prama 815 Hopkins Williamsville NY 14221 Erie 7166880111

Michalek Jr, Leo M. General Practice Michalek, Leo 550 Center Rd West Seneca NY 14224 Erie 7166770100

Raphael, Sami A. General Practice Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Raphael, Sami A. General Practice Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Raphael, Sami A. General Practice Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Raphael, Sami A. General Practice Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Raphael, Sami A. General Practice Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Siddiqui, M Yusuf A. General Practice Sisters of Charity Hospital : St Joseph Campus 1595 Bailey Ave Buffalo NY 14212 Erie 7168938550

Siddiqui, M Yusuf A. General Practice M Yusuf Siddiqui Md 2178 Main St Buffalo NY 14214 Erie 7168388488

Buscaglia, Anthony J. Genetic Counseling Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282180

Aumbhagavan, Sivasubramaniam Geriatric Medicine Inpatient Medical Services PLLC 100 High St Buffalo NY 14213 Erie 7168594234

Aumbhagavan, Sivasubramaniam Geriatric Medicine Inpatient Medical Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7168874798

Berger, Roseanne C. Geriatric Medicine Kaleida Health 1542 Maple Rd Williamsville NY 14221 Erie 7165683400

Berger, Roseanne C. Geriatric Medicine UB Family Medicine Inc 850 Hopkins Rd Williamsville NY 14221 Erie 7166889641

Buslovich, Steven Geriatric Medicine IPC Hospitalist Services of New York, PC 50 Lakefront Blvd Ste 130 Buffalo NY 14202 Erie 7168498750

Cacho, Cele S. Geriatric Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 14225 Erie 7162049711

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 111 Emsminger Tonawanda NY 14150 Erie 7168711814

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 307 Porter Buffalo NY 14201 Erie 7168810565

Carlson Jr, Richard A. Geriatric Medicine Sheridan Medical Group LLP 1491 Sheridan Dr Tonawanda NY 14217 Erie 7163324476

Carlson Jr, Richard A. Geriatric Medicine Sheridan Medical Group LLP 1801 Grand Island Blvd Ste 300 Grand Island NY 14072 Erie 7163324476

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 193 S Union Rd Williamsville NY 14221 Erie 7166326152

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 10 Symphony Cir Buffalo NY 14201 Erie 7168844223

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 1491 Sheridan Dr Ste 100 Buffalo NY 14217 Erie 7163324476

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 2235 Millersport Hwy Getzville NY 14068 Erie 7165041000

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 300 Dorrance Ave Buffalo NY 14220 Erie 7168254984

Carlson Jr, Richard A. Geriatric Medicine Geriatric Associates LLP 2799 Sheridan Dr Tonawanda NY 14150 Erie 7168322252

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Chang, Joan Geriatric Medicine Kaleida Health 3 Gates Cir 9th Fl Buffalo NY 14209 Erie 7168875880

Chang, Joan Geriatric Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168874071

Chang, Joan Geriatric Medicine Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 100 Stahl Rd Getzville NY 14068 Erie 7168107330

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 462 Grider St Buffalo NY 14215 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 150 Bennett Rd Cheektowaga NY 14227 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Chang, Joan Geriatric Medicine Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Collins Jr, James S. Geriatric Medicine Elder Medical Services PC 76 Buffalo St Hamburg NY 14075 Erie 7166497676

Collins Jr, James S. Geriatric Medicine Lakewood Health Care Center 132 Cayuga Rd Ste 1c Cheektowaga NY 14225 Erie 7162049711

Collins Jr, James S. Geriatric Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Cheektowaga NY 14225 Erie 7162049711

Collins Jr, James S. Geriatric Medicine Elder Medical Services PC 5775 Maelou Dr Hamburg NY 14075 Erie 7166482820

Collins Jr, James S. Geriatric Medicine Lakewood Health Care Center 6060 Armor Rd Orchard Park NY 14127 Erie 7166624433

Collins Jr, James S. Geriatric Medicine Elder Medical Services PC 580 Orchard Pk Rd Buffalo NY 14224 Erie 7166774242

Collins Jr, James S. Geriatric Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 14225 Erie 7162049711

Collins Jr, James S. Geriatric Medicine Lakewood Health Care Center 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Collins Jr, James S. Geriatric Medicine Elder Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Collins Jr, James S. Geriatric Medicine Elder Medical Services PC 6060 Armor Rd Orchard Park NY 14127 Erie 7166624433

Comstock, Gordon F. Geriatric Medicine General Physician PC 210 E Main St Springville NY 14141 Erie 7165923600

Dao, Tinh T. Geriatric Medicine CHC of Buffalo INC 34 Benwood Ave Buffalo NY 14214 Erie 7169869199

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 1503 Military Rd Buffalo NY 14217 Erie 7164476600

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Buffalo NY 14225 Erie 7162049711

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 34 Benwood Ave Buffalo NY 14214 Erie 7168622501

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 2157 Main St Buffalo NY 14214 Erie 7168621450

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 291 W North St Buffalo NY 14201 Erie 7168812323

Evans, Stephen J. Geriatric Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7169616995

Evans, Stephen J. Geriatric Medicine Elder Medical Services PC 147 Reist Williamsville NY 14221 Erie 7166335400

Evans, Stephen J. Geriatric Medicine IPC Hospitalist Services of New York, PC 50 Lakefront Blvd Ste 130 Buffalo NY 14202 Erie 7168498750

Page 48 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Evans, Stephen J. Geriatric Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Fu, Cheng Shung Geriatric Medicine Cheng Shung Fu Md Pc 6636 Main St Ste 1 Buffalo NY 14221 Erie 7166330541

Ippolito, Calogero M. Geriatric Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 14225 Erie 7162049711

Ippolito, Calogero M. Geriatric Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1C Cheektowaga NY 14225 Erie 7162049711

Jose, Sheena M. Geriatric Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 2235 Millersport Hwy Getzville NY 14068 Erie 7165041000

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 100 Stahl Rd Getzville NY 14068 Erie 7166886581

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 2799 Sheridan Dr Tonawanda NY 14150 Erie 7168322252

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP Grace Manor 10 Symphony Cir Buffalo NY 14201 Erie 7168847223

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 462 Grider St Buffalo NY 14215 Erie 7168983000

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 3333 Elmwood Ave Buffalo NY 14217 Erie 7168741566

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 193 S Union Rd Williamsville NY 14221 Erie 7166326152

Lawler, Nelda S. Geriatric Medicine Geriatric Associates LLP 300 Dorrance Ave Buffalo NY 14220 Erie 7168254984

Liu Chen, Xinyue Geriatric Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578625

McDonald, Donald A. Geriatric Medicine Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Ramadan, Fadi H. Geriatric Medicine Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168874069

Rosenthal, Thomas C. Geriatric Medicine Kaleida Health 1542 Maple Rd Williamsville NY 14221 Erie 7165683400

Rosenthal, Thomas C. Geriatric Medicine UB Family Medicine Inc 1315 Jefferson Ave Buffalo NY 14208 Erie 7163323797

Rosenthal, Thomas C. Geriatric Medicine Terrace View 1461 Kensington Ave Buffalo NY 14215 Erie 7168318612

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 2235 Millersport Hwy Getzville NY 14068 Erie 7165041000

Sadiq, Riffat Geriatric Medicine Western New York Medical 4979 Harlem Rd Amherst NY 14226 Erie 7169234390

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 100 Stahl Rd Getzville NY 14068 Erie 7166886581

Sadiq, Riffat Geriatric Medicine Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 11580 Walden Ave Alden NY 14004 Erie 7169375690

Sadiq, Riffat Geriatric Medicine Mobile Primary Care Family Nurse Practitioners PLLC 640 Ellicott St Ste 105 Buffalo NY 14203 Erie 7168931010

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 2799 Sheridan Dr Tonawanda NY 14150 Erie 7168322252

Sadiq, Riffat Geriatric Medicine Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 10 Symphony Cir Buffalo NY 14201 Erie 7168844223

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 193 S Union Rd Williamsville NY 14221 Erie 7166326152

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 1175 Delaware Ave Buffalo NY 14209 Erie 7168856733

Sadiq, Riffat Geriatric Medicine Geriatric Associates LLP 2365 Union Rd Cheektowaga NY 14227 Erie 7168262010

Sadiq, Riffat Geriatric Medicine Western New York Medical 154 Cazenovia Buffalo NY 14210 Erie 7168228028

Sadiq, Riffat Geriatric Medicine Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166491342

Siaw, Patrick A. Geriatric Medicine Sisters of Charity Hospital : St Joseph Campus 1500 Broadway Buffalo NY 14212 Erie 7168938550

Siaw, Patrick A. Geriatric Medicine Elder Medical Services PC 2157 Main St Buffalo NY 14214 Erie 7168621984

Smith, Alan C. Geriatric Medicine Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14223 Erie 7164476100

Smith, Alan C. Geriatric Medicine Absolut Center for Nursing and Rehabilitation at Aurora 292 Main St East Aurora NY 14052 Erie 7166521560

Smith, Alan C. Geriatric Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Smith, Alan C. Geriatric Medicine Buffalo Geriatric & Rehabilitation Med 6400 Powers Rd Orchard Park NY 14127 Erie 7166670001

Smith, Gary C. Geriatric Medicine IPC Hospitalist Services of New York, PC 50 Lakefront Blvd Ste 130 Buffalo NY 14202 Erie 7168498750

Stall, Robert S. Geriatric Medicine Stall Geriatrics LLC 350 Greenhaven Ter Tonawanda NY 14150 Erie 7162134345

Stall, Robert S. Geriatric Medicine Robert Stall MD 4248 Ridge Lea Rd Ste 126 Amherst NY 14226 Erie 7162136165

Stall, Robert S. Geriatric Medicine Robert Stall MD 135 Evans St Williamsville NY 14221 Erie 7162134345

Stall, Robert S. Geriatric Medicine Robert Stall MD 350 Greenhaven Terr Tonawanda NY 14150 Erie 7162134345

Thurairajah, Arunan J. Geriatric Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 100 Stahl Rd Getzville NY 14068 Erie 7168107330

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 462 Grider St Buffalo NY 14215 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 1014 Deleware Ave Buffalo NY 14209 Erie 7168836782

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 150 Bennett Rd Cheektowaga NY 14227 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Thurairajah, Arunan J. Geriatric Medicine Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Thurairajah, Arunan J. Geriatric Medicine Rosa Coplon Jewish Home & Infirmary 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Thurairajah, Arunan J. Geriatric Medicine Palliative Care Physicians Group PLLC 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 3333 Elmwood Ave Buffalo NY 14217 Erie 7168741566

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 100 Stahl Rd Getzville NY 14068 Erie 7166886581

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 300 Dorrance Ave Buffalo NY 14220 Erie 7168254984

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 2235 Millersport Hwy Getzville NY 14068 Erie 7165041000

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 10 Symphony Cir Buffalo NY 14201 Erie 7168844223

Page 49 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 2799 Sheridan Dr Tonawanda NY 14150 Erie 7168322252

Tiu Snyderman, Zerline Geriatric Medicine Geriatric Associates LLP 193 S Union Rd Williamsville NY 14221 Erie 7166326152

Ahmed, Syed S. Geriatric Psychiatry Ahmed & Ahmed Physicians PC 8207 Main St Ste 7 And 8 Williamsville NY 14221 Erie 7166264200

Ahmed, Syed S. Geriatric Psychiatry Western New York Medical 4979 Harlem Rd Ste 1 Buffalo NY 14221 Erie 7169234380

Ahmed, Syed S. Geriatric Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Ahmed, Syed S. Geriatric Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166491342

Ahmed, Syed S. Geriatric Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Akers, Stacey N. Gynecologic Oncology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Akers, Stacey N. Gynecologic Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Baker, Trudy R. Gynecologic Oncology Gynecologic Oncology Associates 1020 Youngs Rd Ste 130 Williamsville NY 14221 Erie 7166898398

Baker, Trudy R. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 55 Spindrift Ste 220 Williamsville NY 14221 Erie 7166898398

Baker, Trudy R. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Chitgar, Sahar Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 626 Frankhauser Rd Williamsville NY 14221 Erie 7162769162

Frederick, Peter J. Gynecologic Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Lele, Shashikant B. Gynecologic Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Marchetti, David L. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Marchetti, David L. Gynecologic Oncology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Marchetti, David L. Gynecologic Oncology Gynecologic Oncology Associates 2157 Main St Buffalo NY 14214 Erie 7168621965

Marchetti, David L. Gynecologic Oncology Gynecologic Oncology Associates Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Marchetti, David L. Gynecologic Oncology Gynecologic Oncology Associates 1020 Youngs Rd Ste 130 Williamsville NY 14221 Erie 7166898398

Marchetti, David L. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 55 Spindrift Ste 220 Williamsville NY 14221 Erie 7166898398

Odunsi, Adekunle O. Gynecologic Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Piver, M Steven Gynecologic Oncology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Piver, M Steven Gynecologic Oncology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Singhal, Pankaj K. Gynecologic Oncology General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Singhal, Pankaj K. Gynecologic Oncology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Singhal, Pankaj K. Gynecologic Oncology General Physician PC 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166564077

Singhal, Pankaj K. Gynecologic Oncology Gynecologic Oncology Associates 626 Frankhauser Rd Buffalo NY 14221 Erie 7162183887

Singhal, Pankaj K. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14221 Erie 7166744006

Singhal, Pankaj K. Gynecologic Oncology University Gynecologists & Obstetriciansstate Universit 1150 Youngs Rd Ste 208 Williamsville NY 14221 Erie 7166369112

Singhal, Pankaj K. Gynecologic Oncology General Physician PC 224 E Main St Springville NY 14141 Erie 7165928151

Singhal, Pankaj K. Gynecologic Oncology General Physician PC 120 Gardenville Pkwy Buffalo NY 14224 Erie 7166564077

Singhal, Pankaj K. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 1020 Youngs Rd Ste 130 Williamsville NY 14221 Erie 7166898398

Singhal, Pankaj K. Gynecologic Oncology General Physician PC 1026 Union Rd Ste 1 Buffalo NY 14224 Erie 7167121862

Singhal, Pankaj K. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Williamsville NY 14221 Erie 7165650355

Singhal, Pankaj K. Gynecologic Oncology CCS Medical PLLC dba Century Medical Associates 626 Frankhauser Rd Williamsville NY 14221 Erie 7165650355

Zsiros, Emese Gynecologic Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Balti, Mubeena A. Gynecology only Balti, Mubeena 350 Alberta Dr Eggertsville NY 14226 Erie 7168368380

Baughman, Renee T. Gynecology only Womens Medicine of Niagara PLLC 1801 Grand Island Blvd Ste 300 Grand Island NY 14072 Erie 7162979379

Cellino, Ivonne S. Gynecology only Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564802

Gallego, Myrna S. Gynecology only Gallego, Myrna 18 Willow Ridge Dr Amherst NY 14228 Erie 7166914228

Genewick, Tiffany B. Gynecology only Genewick, Tiffany 4731 Transit Rd Ste 1 Lancaster NY 14043 Erie 7166681902

Kurss, David I. Gynecology only David I Kurss MD PLLC 835 Hopkins Rd Williamsville NY 14221 Erie 7166880500

Kurss, David I. Gynecology only Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Williamsville NY 14221 Erie 7168757399

McLellan Desai, Mary A. Gynecology only General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

McLellan Desai, Mary A. Gynecology only General Physician PC 1275 Delware Ave Buffalo NY 14209 Erie 7168822424

McLellan Desai, Mary A. Gynecology only General Physician PC 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7167120862

McLellan Desai, Mary A. Gynecology only General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

McLellan Desai, Mary A. Gynecology only General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

McLellan Desai, Mary A. Gynecology only General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

McLellan Desai, Mary A. Gynecology only General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Meyers, Suzanne J. Gynecology only Meyers, Suzanne 3580 Sheridan Dr Ste 110 Amherst NY 14226 Erie 7168310102

Pieczonka, Sheila M. Gynecology only Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Saleeb, Samuel Gynecology only Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Saleeb, Samuel Gynecology only Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Saleeb, Samuel Gynecology only Saleeb, Samuel 2318 Wehrle Dr Williamsville NY 14221 Erie 7166331112

Sperrazza, Ralph C. Gynecology only Infertility & IVF Medical Assoc 4510 Main St Buffalo NY 14226 Erie 7168393057

Sterman, Ellen B. Gynecology only Audubon Womens Medical Assoc Pc 1360 N Forest Rd Ste 102 Buffalo NY 14221 Erie 7166394034

Sutter, Diane J. Gynecology only Sutter, Diane J. 3800 Delaware Ave Ste 102 Kenmore NY 14217 Erie 7166505548

Sutter, Diane J. Gynecology only George Danakas 268 Main St East Aurora NY 14052 Erie 7166528606

Szumigala, Julie A. Gynecology only Women First Healthcare Of Wny Pc 240 Redtail Dr Ste 5 and 6 Orchard Park NY 14127 Erie 7166770454

Szumigala, Julie A. Gynecology only General Physician PC 1275 Delaware Ave Buffalo NY 14209 Erie 7168822424

Szumigala, Julie A. Gynecology only General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Szumigala, Julie A. Gynecology only General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Szumigala, Julie A. Gynecology only General Physician PC 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166564077

Szumigala, Julie A. Gynecology only General Physician PC 120 Gardenville Pkwy Buffalo NY 14224 Erie 7166564077

Page 50 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Szumigala, Julie A. Gynecology only General Physician PC 1026 Union Rd Ste 1 Buffalo NY 14224 Erie 7167120862

Zuccala, Scott J. Gynecology only Hamburg Gyn & Ob Group 4154 Mckinley Pkwy Ste 1200 Buffalo NY 14219 Erie 7166496500

Zuccala, Scott J. Gynecology only Lakeshore Primary Care Associates LLP 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166461084

Ablove, Robert H. Hand Surgery University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043201

Ablove, Robert H. Hand Surgery University Orthopaedics Services Inc 100 High St Buffalo NY 14203 Erie 7168591256

Brown, Robert K. Hand Surgery Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Callahan Jr, John J. Hand Surgery VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7168983000

Kelly Jr, James J. Hand Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Kelly Jr, James J. Hand Surgery Excelsior Orthopaedics Llp 240 Red Tail Stes 1 and 2 Orchard Park NY 14127 Erie 7162509999

McGrath, Timothy V. Hand Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Moy, Owen J. Hand Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Reed, Kory B. Hand Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Reed, Kory B. Hand Surgery Excelsior Orthopaedics Llp 240 Red Tail Stes 1 and 2 Orchard Park NY 14127 Erie 7162509999

Wheeler, Dale Hand Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Ahmed, Mohamed S. Hematology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

AlHattab, Eyad S. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Berenji, Farid Hematology Century Medical Associates 45 Spindrift Dr Ste 100 Buffalo NY 14221 Erie 7165650355

Bhat, Seema A. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Boland, Patrick M. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Botsoglou, Nikolaos K. Hematology Botsoglou, Nikolaos 2475 Harlem Rd Cheektowaga NY 14225 Erie 7168965922

Chen, George L. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Cheng, Yijun Hematology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Duvivier, Herbert L. Hematology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14224 Erie 7166744006

Duvivier, Herbert L. Hematology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Dy, Grace K. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Griffiths, Elizabeth A. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Islam, Abul Hematology Islam, Abul 100 High St Rm E318 Buffalo NY 14203 Erie 7168591399

Islam, Abul Hematology Islam, Abul 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Kanj, Ola S A. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14203 Erie 7168452300

Kotowski, Adam S. Hematology RPCI Oncology PC 199 Park Club Ln Ste 200 Williamsville NY 14221 Erie 7166343340

Krabak, Michael J. Hematology Century Medical Associates 45 Spindrift Dr Ste 100 Buffalo NY 14221 Erie 7165650355

Liu, Hong Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Thompson, James E. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Wang, Eunice S. Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Zhao, Yujie Hematology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Berenji, Farid Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Cheng, Yijun Hematology Oncology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301048

Cheng, Yijun Hematology Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301204

Holstein, Sarah A. Hematology Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Hong, Frederick Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Khadim, Haider A. Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Khadim, Haider A. Hematology Oncology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14224 Erie 7166744006

Krabak, Michael J. Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Ramkumar, Bhuvaneswari G. Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Romanowski, Roslyn R. Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Steinbrenner, Lynn M. Hematology Oncology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Wang, Yubao Hematology Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Wang, Yubao Hematology Oncology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14224 Erie 7166744006

Banas, Anne C. Hospice & Palliative Med Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 462 Grider St Buffalo NY 14215 Erie 7166868460

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 150 Bennett Rd Buffalo NY 142271443 Erie 7166868460

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 100 Stahl Rd Getzville NY 14068 Erie 7168107330

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Banas, Anne C. Hospice & Palliative Med Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Freer, Jack P. Hospice & Palliative Med Academic Medicine Services 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Freer, Jack P. Hospice & Palliative Med Kaleida Health 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Maher, Elizabeth L. Hospice & Palliative Med Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Obear, Mary E. Hospice & Palliative Med United Memorial Medical Center 372 Bloomingdale Rd Akron NY 14001 Erie 5855425230

Satchidanand, Yashodhara K. Hospice & Palliative Med Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Schneider, Jaclyn M. Hospice & Palliative Med Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Page 51 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Tangeman, John C. Hospice & Palliative Med Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166868131

Walter, Michelle M. Hospice & Palliative Med Palliative Care Physicians Group PLLC 2157 Main St Buffalo NY 14214 Erie 7166868460

Walter, Michelle M. Hospice & Palliative Med Palliative Care Physicians Group PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166868460

Walter, Michelle M. Hospice & Palliative Med Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Walter, Michelle M. Hospice & Palliative Med Palliative Care Physicians Group PLLC 150 Bennett Rd Cheektowaga NY 14227 Erie 7166868460

Chen, Frank Immunopathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Chen, Frank Immunopathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Almyroudis, Nikolaos Infectious Diseases Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Antalek, Matthew D. Infectious Diseases Antalek, Matthew 1829 Maple Rd Ste 202 Williamsville NY 14221 Erie 7162045933

Antalek, Matthew D. Infectious Diseases Internal Med ID Associates, LLC. 1829 Maple Rd Ste 202 Williamsville NY 14221 Erie 7162045933

Antalek, Matthew D. Infectious Diseases Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984800

Brass, Corstiaan Infectious Diseases Buffalo Medical Group 2355 Union Rd Cheektowaga NY 14227 Erie 7168578603

Claus, Jonathan A. Infectious Diseases Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Crane, John K. Infectious Diseases Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984808

Crane, John K. Infectious Diseases VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7168983000

Crane, John K. Infectious Diseases Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168587687

Cumbo, Thomas A. Infectious Diseases T. Anthony Cumbo, MD PLLC 1150 Youngs Rd Ste 207 Williamsville NY 14221 Erie 7166881480

Cumbo, Thomas J. Infectious Diseases Cumbo, Thomas 1150 Youngs Rd Ste 207 Williamsville NY 14221 Erie 7166881480

Frost, Jeffrey B. Infectious Diseases Internal Med ID Associates, LLC. 1829 Maple Rd Ste 202 Williamsville NY 14221 Erie 7162045933

Hermogenes, Alicia W. Infectious Diseases Hermogenes, Alicia 2925 Genesee St Cheektowaga NY 14225 Erie 7168915071

Hermogenes, Alicia W. Infectious Diseases Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482119

Hermogenes, Alicia W. Infectious Diseases Hermogenes, Alicia 2157 Main St Buffalo NY 14214 Erie 7168621965

Hermogenes, Alicia W. Infectious Diseases Hermogenes, Alicia 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Hermogenes, Alicia W. Infectious Diseases Alicia W Hermogenes MD 2925 Genesee St Cheektowaga NY 14225 Erie 7168945071

Ho, John L. Infectious Diseases Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Hocko, Michael Infectious Diseases Hocko, Michael 1616 Kensington Ave Buffalo NY 14215 Erie 7168933836

Lesse, Alan J. Infectious Diseases VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168628758

Martinez, Jeffrey W. Infectious Diseases Internal Med ID Associates, LLC. 1829 Maple Rd Ste 202 Williamsville NY 14221 Erie 7162045933

Merchant, Shehzad S. Infectious Diseases Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Merchant, Shehzad S. Infectious Diseases Academic Medicine Services Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Osawa, Ryosuke Infectious Diseases Kaleida Health 100 High St Specialty Care Ctr Buffalo NY 14203 Erie 7168591671

Osawa, Ryosuke Infectious Diseases Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168587687

Osawa, Ryosuke Infectious Diseases Kaleida Health 100 High St Specialty Care Ctr DB Buffalo NY 14203 Erie 7168591671

Osawa, Ryosuke Infectious Diseases Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Park, Sun O. Infectious Diseases Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984119

Park, Sun O. Infectious Diseases Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Pomakova, Diana K. Infectious Diseases Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282578

Raab, Thomas A. Infectious Diseases Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282578

Salazar Moreno, Wayra Y. Infectious Diseases Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Segal, Brahm H. Infectious Diseases Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Shiley, Kevin T. Infectious Diseases Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282578

Shon, Alyssa Infectious Diseases Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984119

Shon, Alyssa Infectious Diseases Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Shon, Alyssa Infectious Diseases Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7168826544

Sulaiman, Adel S. Infectious Diseases Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Sulaiman, Adel S. Infectious Diseases Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Swiencicki Jr, James F. Infectious Diseases Internal Med ID Associates, LLC. 1829 Maple Rd Ste 202 Williamsville NY 14221 Erie 7162045933

Abialmouna, Jihad H. Internal Medicine Tonawanda Medical Practice PC 2800 Sweethome Rd Ste 6 West Amherst NY 14228 Erie 7166911300

Abialmouna, Jihad H. Internal Medicine Tonawanda Medical Practice PC 2882 Elmwood Ave Kenmore NY 14217 Erie 7166911300

Adham, Hanaw A. Internal Medicine The Queen City Internal Medicine of WNY PC 2799 Sheridan Dr Tonawanda NY 14150 Erie 7168374466

Adham, Hanaw A. Internal Medicine The Queen City Internal Medicine of WNY PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Adham, Hanaw A. Internal Medicine The Queen City Internal Medicine of WNY PC 3 Gates Circle Buffalo NY 14209 Erie 7168874600

Adrian, Peter G. Internal Medicine Inpatient Medical Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7168874798

Adrian, Peter G. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

Adrian, Peter G. Internal Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1C Buffalo NY 14225 Erie 7162049711

Adrian, Peter G. Internal Medicine Elder Medical Services PC 1818 Como Park Blvd Lancaster NY 14086 Erie 7166836165

Adrian, Peter G. Internal Medicine Inpatient Medical Services PLLC 100 High St Buffalo NY 14213 Erie 7168594234

Adrian, Peter G. Internal Medicine Adrian, Peter 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476096

Ahmad, Anees Internal Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Ahmad, Anees Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7166944500

Ahmad, Anees Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166944500

Ali, Irshad Internal Medicine Ali, Irshad 357 Englewood Ave Buffalo NY 14223 Erie 7168355869

Andaya, Maria Rita P. Internal Medicine Andaya, Maria Rita 15 Melroy Ave Lackawanna NY 14218 Erie 7168210170

Artim, Thomas S. Internal Medicine Cleveland Hill Medical Group 539 Cleveland Dr Cheektowaga NY 14225 Erie 7168349486

Banday, Shahid M. Internal Medicine Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Banday, Shahid M. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

Page 52 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Bastible, Deirdre M. Internal Medicine Parkview Primary Care Physicians 20 Losson Rd Ste 105 Buffalo NY 14227 Erie 7165587727

Becker, Steven B. Internal Medicine Cleveland Hill Medical Group 539 Cleveland Dr Cheektowaga NY 14225 Erie 7168349486

Bertulfo, Romel A. Internal Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Bhattacharyya, Jadab K. Internal Medicine Bhattacharyya, Jadab 534 Abbott Rd Buffalo NY 14220 Erie 7168228078

Boepple, Hartwig O. Internal Medicine The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

Botsoglou, Nikolaos K. Internal Medicine Botsoglou, Nikolaos 2475 Harlem Rd Cheektowaga NY 14225 Erie 7168965922

Branigan, Thomas S. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Branigan, Thomas S. Internal Medicine Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Branigan, Thomas S. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168240266

Brewer, Thomas J. Internal Medicine Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Brewer, Thomas J. Internal Medicine Exigence Hospitalist Medical Services of Erie County PL 462 Grider St Buffalo NY 14215 Erie 7169616995

Brewer, Thomas J. Internal Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Ste 2034 Kenmore NY 14217 Erie 7164476696

Brewer, Thomas J. Internal Medicine Buffalo Internal Medicine PLLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Brewer, Thomas J. Internal Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592260

Burns, Linda M. Internal Medicine Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Butt, Ayesha Internal Medicine Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Butt, Ayesha Internal Medicine Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Byers, Rositsa I. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Capaccio, David L. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

Carlson Jr, Richard A. Internal Medicine Sheridan Medical Group LLP 1801 Grand Island Blvd Ste 300 Grand Island NY 14072 Erie 7163324476

Carlson Jr, Richard A. Internal Medicine Sheridan Medical Group LLP 1491 Sheridan Dr Ste 100 Tonawanda NY 14217 Erie 7163324476

Chatrath, Alka Internal Medicine MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Chau, Teresa P. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Chau, Teresa P. Internal Medicine Buffalo Geriatric & Rehabilitation Med 100 Stahl Rd Getzville NY 14068 Erie 7166888822

Chau, Teresa P. Internal Medicine Episcopal Church Home 24 Rhode Island St Buffalo NY 14213 Erie 7168846500

Chau, Teresa P. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Chaudhuri, Jayanta Internal Medicine Niagara Falls Memorial Medical Center 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167736181

Chrzanowski, Stephen G. Internal Medicine Mercy Hospital 565 Abbott Rd Dept of Medicine Buffalo NY 14220 Erie 7168282898

Cleary, Kevin G. Internal Medicine Lancaster Medical LLC 4893 Transit Rd Depew NY 14043 Erie 7166087040

Cline, William B. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Buffalo NY 14225 Erie 7166944500

Cline, William B. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7166944500

Cline, William B. Internal Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Curran, Richard R. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Curran, Richard R. Internal Medicine Buffalo Medical Group 2121 Main St Ste 305 Buffalo NY 14214 Erie 7168328063

Dara, Tanvir M. Internal Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168282666

Dara, Tanvir M. Internal Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621810

Dara, Tanvir M. Internal Medicine Exigence Medical of Binghamton PLLC 6653 Main St Williamsville NY 14221 Erie 9048051010

Dara, Tanvir M. Internal Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Dara, Tanvir M. Internal Medicine Buffalo Emergency Associates 2950 Elmwood Ave Emergency Dept Kenmore NY 14217 Erie 7164476100

Dara, Tanvir M. Internal Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Dara, Tanvir M. Internal Medicine Buffalo Emergency Associates 2605 Harlem Rd Emergency Dept Cheektowaga NY 14225 Erie 7168912400

De Perio III, Jose A. Internal Medicine De Perio, Jose 571 Terrace Blvd Depew NY 14043 Erie 7166834196

Dean, David C. Internal Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Dean, David C. Internal Medicine David Dean MD 65 Huxley Dr Buffalo NY 14226 Erie 7068393085

Dean, David C. Internal Medicine David Dean MD 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Dean, David C. Internal Medicine David Dean MD 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Dean, David C. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

D'Eon, Lisette A. Internal Medicine Keystone Hospitalist Service of NY PC 224 E Main St Springville NY 14141 Erie 7165922871

D'Eon, Lisette A. Internal Medicine Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922891

Dibella, Michael D. Internal Medicine Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Dibella, Michael D. Internal Medicine Professional Emergency Services PLLC 100 High St Buffalo NY 14203 Erie 7166918838

Dibella, Michael D. Internal Medicine Professional Emergency Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686550

Dibella, Michael D. Internal Medicine Professional Emergency Services PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874880

Dibella, Michael D. Internal Medicine Dibella, Michael D. 1191 Bowen Rd Elma NY 14059 Erie 7166552690

Dibella, Michael D. Internal Medicine Dibella, Michael D. 283 Huxley Dr Buffalo NY 14226 Erie 7166552690

Dibella, Michael D. Internal Medicine FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Dibella, Michael D. Internal Medicine Dibella, Michael D. 565 Abbott Rd Buffalo NY 14220 Erie 7168282579

Ding, Yongzeng Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

DiPirro, Joseph C. Internal Medicine CCS Oncology PC 2625 Harlem Rd Ste 180 Cheektowaga NY 14225 Erie 7168931697

Dombrowski, Jacqueline A. Internal Medicine Southtowns Medicine and Pediatrics, PC 268 Main St East Aurora NY 14052 Erie 7167143937

Domondon Jr, Fernando B. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Eluard, Alain Internal Medicine Eluard, Alain 1412 Sweet Home Rd Ste 5 Amherst NY 14228 Erie 7168754500

Eluard, Alain Internal Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Faisal, Shah Internal Medicine Buffalo-Niagara Hospitalists LLC 2950 Elmwood Ave Kenmore NY 142171304 Erie 7164476100

Faisal, Shah Internal Medicine Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Page 53 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 100 Stahl Rd Getzville NY 14068 Erie 7168107330

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 150 Bennett Rd Cheektowaga NY 14227 Erie 7166868460

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Farrell, Megan O. Internal Medicine Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 292 Main St Buffalo NY 14222 Erie 7169892060

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Farrell, Megan O. Internal Medicine Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Farrugia Jr, David J. Internal Medicine Keystone Hospitalist Service of NY PC 224 E Main St Springville NY 14141 Erie 7165922871

Farrugia Jr, David J. Internal Medicine IPC Hospitalist Services of New York, PC 50 Lakefront Blvd Ste 130 Buffalo NY 14202 Erie 7168498750

Forehand, Lisa G. Internal Medicine Lakeshore Primary Care Associates LLP 4855 Camp Rd ste 100 Hamburg NY 14075 Erie 7166461084

Fu, Cheng Shung Internal Medicine Cheng Shung Fu Md Pc 6636 Main St Ste 1 Williamsville NY 14221 Erie 7166330541

Fu, Philip D. Internal Medicine Cheng Shung Fu Md Pc 6636 Main St Ste 1 Williamsville NY 14221 Erie 7166330541

Gabryel, Timothy F. Internal Medicine Timothy Gabryel Mdpc 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166750707

Gaines, Katherine C. Internal Medicine IPC Hospitalist Services of New York, PC 565 Abbott Rd Buffalo NY 14220 Erie 7162049711

Gais, Dawn A. Internal Medicine Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166776060

Gais, Dawn A. Internal Medicine Buffalo Medical Group 2741 Transit Rd Elma NY 14059 Erie 7166776060

Ghosh, Subrato Internal Medicine Elder Medical Services PC 2157 Main St Buffalo NY 14214 Erie 7168621450

Ghosh, Subrato Internal Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1c Cheektowaga NY 14225 Erie 7162049711

Ghosh, Subrato Internal Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 142251942 Erie 7162049711

Ghosh, Subrato Internal Medicine Elder Medical Services PC 1503 Military Rd Kenmore NY 14217 Erie 7164476600

Ghosh, Subrato Internal Medicine Elder Medical Services PC 34 Benwood Ave Buffalo NY 14214 Erie 7168622501

Gugino, Lawrence J. Internal Medicine University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Gullickson II, Donald E. Internal Medicine Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Gullickson II, Donald E. Internal Medicine Northtowns Medical Group 1783 Colvin Blvd Buffalo NY 14223 Erie 7168742150

Gunasingham, Vyjanthanath R. Internal Medicine Vyjanthanath Rohan Gunasingham MD 725 Orchard Park Rd Ste D West Seneca NY 14224 Erie 7167486002

Gunther, David E. Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Gupta, Alok D. Internal Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168594738

Gupta, Alok D. Internal Medicine Inpatient Medical Services PLLC 100 High St Buffalo NY 14213 Erie 7168594234

Gupta, Alok D. Internal Medicine Inpatient Medical Services PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7168874798

Guth, Kenneth J. Internal Medicine Southtowns Internal Medicine 3320 N Benzing Rd Orchard Park NY 14127 Erie 7168250300

Haddad, George A. Internal Medicine Haddad, George 3800 Delaware Ave Ste 100 Kenmore NY 14217 Erie 7168763737

Hall, John D. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Hall, John D. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Hall, John D. Internal Medicine R & B Medical Group Llp 297 Spindrift Dr Ste 200 Williamsville NY 14221 Erie 7166350688

Haq, Syed E. Internal Medicine Haq, Syed 474 Niagara Falls Blvd Tonawanda NY 14223 Erie 7168333697

Haq, Syed E. Internal Medicine Haq, Syed 1826 Whitehaven Rd Grand Island NY 14072 Erie 7167736650

Haq, Syed E. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168332073

Haq, Syed E. Internal Medicine Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168874600

Haque, Shehla Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Haque, Shehla Internal Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hartman, David A. Internal Medicine Amherst Medical Associates LLP 6000 N Bailey Ave Ste 1d Amherst NY 14226 Erie 7168344266

Heidelberger, Edwin Internal Medicine Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Herle, P Anandaram Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hobbs, Randy L. Internal Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Hobbs, Randy L. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Buffalo NY 14220 Erie 7168787701

Hoffman, Lisa B. Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Honeine, Roland A. Internal Medicine Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Ippolito, Calogero M. Internal Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1C Cheektowaga NY 14225 Erie 7162049711

Jain, Rajiv K. Internal Medicine University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Jain, Rajiv K. Internal Medicine University Orthopaedics Services Inc 1026 Union Rd West Seneca NY 14224 Erie 7162043200

Jain, Rajiv K. Internal Medicine University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168295499

Jain, Rajiv K. Internal Medicine Sheridan Medical Group LLP 1491 Sheridan Dr Ste 100 Tonawanda NY 14217 Erie 7163324476

Jain, Rajiv K. Internal Medicine University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7162043200

Janes, Peter T. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7163944500

Janes, Peter T. Internal Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Janes, Peter T. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166944500

Jeyapalan, Soosaipillai G. Internal Medicine Timothy Gabryel Mdpc 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166750707

Joven, Pedro Internal Medicine Joven, Pedro 162 George Urban Blvd Cheektowaga NY 14225 Erie 7168956826

Jupudy, Venkata R. Internal Medicine Venkata Ratnam Jupudy, MD 1540 Maple Rd Buffalo NY 14221 Erie 7169373255

Jupudy, Venkata R. Internal Medicine Alden Medical Group 12845 Broadway Alden NY 14004 Erie 7169373255

Jupudy, Venkata R. Internal Medicine Venkata Ratnam Jupudy, MD 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166552690

Kalakada, Nirisha Internal Medicine Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Kalmuk Jr, Eugene J. Internal Medicine Preferred Physician Care PC 290 Center Rd Ste 206 West Seneca NY 14224 Erie 7166086116

Page 54 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kalmuk Jr, Eugene J. Internal Medicine Trinity Medical WNY PC 2625 Harlem Rd Ste 180 Cheektowaga NY 14225 Erie 7168934797

Kalra, Tejinder Internal Medicine Kalra, Tejinder 2671 Harlem Rd Buffalo NY 14225 Erie 7168929670

Kansal, Sarita Internal Medicine Sarita Kansal Md 725 Orchard Park Rd West Seneca NY 14224 Erie 7166740101

Karaszewski, Brian M. Internal Medicine Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Karaszewski, Brian M. Internal Medicine Karaszewski, Brian 1412 Sweet Home Rd Ste 6 Buffalo NY 14228 Erie 7166881412

Kawinski, Bohdan J. Internal Medicine Western New York Medical 3884 Broadway St Buffalo NY 14227 Erie 7169234380

Kawinski, Bohdan J. Internal Medicine Kawinski, Bohdan 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Kawinski, Bohdan J. Internal Medicine Western New York Medical 4979 Harlem Rd Amherst NY 14226 Erie 7169234380

Keefe, James T. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7168282434

Kelly, Mary A. Internal Medicine Timothy Gabryel Mdpc 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166750707

Khawar, Sarwat Internal Medicine Khawar, Sarwat 8205 Main St Ste 14 Williamsville NY 14221 Erie 7166323535

Khawar, Sarwat Internal Medicine Keystone Hospitalist Service of NY PC 224 E Main St Springville NY 14141 Erie 7165922871

Khawar, Sarwat Internal Medicine Khawar, Sarwat 224 E Main St Springville NY 14141 Erie 7165929662

Khozina, Malvina Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

Kim, Edward G. Internal Medicine Genesee Valley Group Health Association Lifetime Health 2075 Sheridan Dr Buffalo NY 14223 Erie 7168741850

Koch, Eric J. Internal Medicine R & B Medical Group Llp 297 Spindrift Dr Ste 200 Williamsville NY 14221 Erie 7166350688

Koch, Eric J. Internal Medicine Buffalo-Niagara Hospitalists LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Kotowski, Adam S. Internal Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kumar, Yellamraju R. Internal Medicine Alden Medical Group 12845 Broadway Alden NY 14004 Erie 7169373255

Kuwik, Lauren M. Internal Medicine O'Connor Medical Group LLP 3075 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7167120490

Leone, John A. Internal Medicine Family Care Physicians 61 Maple Rd Williamsville NY 14221 Erie 7165651234

Luthra, Pramod Internal Medicine Pramod Luthra Md 2075 Kensington Ave Snyder NY 14226 Erie 7168391161

Maddi, Joseph L. Internal Medicine Joseph L Maddi Physician PC 4225 Maple Rd Amherst NY 14226 Erie 7168340295

Maddi, Joseph L. Internal Medicine Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Maddi, Joseph L. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168332073

Maddi, Joseph L. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Mahran, Khalid S. Internal Medicine Kidney Care PC 2121 Main St Ste 216 Buffalo NY 14214 Erie 7168331511

Mamnoon, Sameer S. Internal Medicine Adult Medical Services PC 6645 Main St Ste A Williamsville NY 14221 Erie 7162768726

Mamnoon, Sameer S. Internal Medicine Adult Health NP All About You Primary Care PC 2234 Seneca St Buffalo NY 14210 Erie 7163147817

Mangulabnan, Melvin S. Internal Medicine Mangulabnan, Melvin 3918 Seneca St West Seneca NY 14224 Erie 7166754433

Manzoor, Shaikh A. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

Manzoor, Shaikh A. Internal Medicine IPC Hospitalist Services of New York, PC 132 Cayuga Rd Cheektowaga NY 14225 Erie 7162049711

Manzoor, Shaikh A. Internal Medicine Elder Medical Services PC 132 Cayuga Rd Ste 1 C Cheektowaga NY 14225 Erie 7162049711

Martinez, Carlos L. Internal Medicine Martinez, Carlos 2291 Union Rd West Seneca NY 14224 Erie 7166686146

Mathur, Anil K. Internal Medicine Mathur, Anil 5285 Main St Williamsville NY 14221 Erie 7166319477

Mazepa, Erzsebet A. Internal Medicine Timothy Gabryel Mdpc 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166750707

Melgar, Luis Internal Medicine Luis Melgar Md 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Melgar, Luis Internal Medicine Luis Melgar Md 5775 Maelou Dr Hamburg NY 14075 Erie 7166482820

Melgar, Luis Internal Medicine Luis Melgar Md 5893 Camp Rd Ste 3 Hamburg NY 14075 Erie 7166487401

Merrill, Michael D. Internal Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Merrill, Michael D. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166944500

Merrill, Michael D. Internal Medicine John A Brach MD PC DBA Buffalo Hospitali 2605 HARLEM RD Buffalo NY 14225 Erie 7168912400

Merrill, Michael D. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7166944500

Michalski, Stanley R. Internal Medicine Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Michalski, Stanley R. Internal Medicine Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Missert, Matthew J. Internal Medicine Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Missert, Matthew J. Internal Medicine Buffalo-Niagara Hospitalists LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Molloy, Daniel J. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282472

Mucciarella, Rosalba Internal Medicine R & B Medical Group Llp 297 Spindrift Dr Ste 200 Williamsville NY 14221 Erie 7166350688

Mylotte, Joseph M. Internal Medicine Buffalo Geriatric & Rehabilitation Med S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Mylotte, Joseph M. Internal Medicine Mylotte, Joseph M. 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Mylotte, Joseph M. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Namassivaya, Arundathi Internal Medicine Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Namassivaya, Arundathi Internal Medicine Nephrology Associates of Western NY LLP 220 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7167120864

Naughton, Bruce J. Internal Medicine Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Naughton, Bruce J. Internal Medicine Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Naughton, Bruce J. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Naughton, Bruce J. Internal Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168874021

Naughton, Bruce J. Internal Medicine Mercy Hospital 2157 Main St Buffalo NY 14217 Erie 7168621000

Naughton, Bruce J. Internal Medicine Academic Medicine Services Deaconess Cnt 1001 Humboldt Pkwy Buffalo NY 14208 Erie 7168878200

Naughton, Bruce J. Internal Medicine Mercy Hospital 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Naughton, Bruce J. Internal Medicine Academic Medicine Services Waterfront Snf 200 Seventh St Buffalo NY 14201 Erie 7168472500

Nelson, Gary R. Internal Medicine Southtowns Internal Medicine 3320 N Benzing Rd Orchard Park NY 14127 Erie 7168250300

Newman, Jay L. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Noack, Annaliese Internal Medicine Buffalo Medical Group 2741 Transit Rd Elma NY 14059 Erie 7166776060

Noack, Annaliese Internal Medicine Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166776060

Page 55 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Norman, Allyn M. Internal Medicine Norman, Allyn 1825 Maple Rd Ste 100 Williamsville NY 14221 Erie 7162044532

O Connor, Gale Internal Medicine O'Connor Medical Group LLP 3075 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7167120490

O Connor, Terence P. Internal Medicine O'Connor Medical Group LLP 3075 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7167120490

O Gorman, Kevin N. Internal Medicine O'Gorman, Kevin 8600 Depot St Eden NY 14057 Erie 7169924999

O Neil, David C. Internal Medicine O'Neil, David 3755 Abbott Rd Orchard Park NY 14127 Erie 7166494454

Ogra, Sanjay R. Internal Medicine Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Ogra, Sanjay R. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Ogra, Sanjay R. Internal Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Parker, Jeffrey M. Internal Medicine FKA WNY Hospitalist Medical Services PLLC 565 Abbott Rd Buffalo NY 14220 Erie 7162044500

Parker, Jeffrey M. Internal Medicine Parker, Jeffrey M. 565 Abbott Rd Mercy Hospital Buffalo NY 14220 Erie 7164795761

Pathak, Yashash D. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7164726861

Pelechaty Jr, Michael J. Internal Medicine FKA WNY Hospitalist Medical Services PLLC 1026 Union Rd Buffalo NY 14224 Erie 7167120851

Pelechaty Jr, Michael J. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Pelechaty Jr, Michael J. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Pendyala, Prashant Internal Medicine Terrace View 462 Grider st Buffalo NY 14215 Erie 7168983000

Pendyala, Prashant Internal Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Penepent Jr, Philip A. Internal Medicine Penepent, Philip 5196 Genesee St Bowmansville NY 14026 Erie 7166811895

Perna, Anthony F. Internal Medicine Perna, Anthony 1430 Colvin Blvd Tonawanda NY 14223 Erie 7168744060

Peters, Nancy J. Internal Medicine Associated Physicians Of Western New York Pc 1616 Kensington Ave Buffalo NY 14215 Erie 7168353097

Pleskow, Sanford R. Internal Medicine Kenmore Physician Association 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476671

Pleskow, Sanford R. Internal Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Pleskow, Sanford R. Internal Medicine Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Pleskow, Sanford R. Internal Medicine Kenmore Mercy Hospital 400 International Dr Buffalo NY 14221 Erie 7166313555

Polataiko, Nadezhda Internal Medicine Kenmore Mercy Hospital 300 Two Mile Crk Rd Tonawanda NY 14150 Erie 7164476450

Qazi, Khalid J. Internal Medicine Qazi, Khalid 6343 Transit Rd Depew NY 14043 Erie 7166831840

Qazi, Khalid J. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168622000

Quebral, Agnes V. Internal Medicine Timothy Gabryel Mdpc 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166750707

Quebral, Agnes V. Internal Medicine Andaya, Maria Rita 15 Melroy Ave Lackawanna NY 14218 Erie 7168210170

Quebral, Agnes V. Internal Medicine Andaya, Maria Rita 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Quebral, Agnes V. Internal Medicine Andaya, Maria Rita 286 N Main St Lancaster NY 14086 Erie 7165494724

Rados, Philip J. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282898

Rados, Philip J. Internal Medicine Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Rados, Philip J. Internal Medicine Mercy Hospital 430 S Park Ave Buffalo NY 14204 Erie 7168476610

Rajeswary, Jyotsna Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Rajeswary, Jyotsna Internal Medicine Buffalo Geriatric & Rehabilitation Med 100 Stahl Rd Beechwood Nursing Home Getzville NY 14068 Erie 7166888822

Rajeswary, Jyotsna Internal Medicine Buffalo Geriatric & Rehabilitation Med 1 Fox Run Ln Fox Run at Orchard Park Orchard Park NY 14127 Erie 7166625001

Rajeswary, Jyotsna Internal Medicine Buffalo Geriatric & Rehabilitation Med 2365 Union Rd Garden Gate Health Facility Cheektowaga NY 14225 Erie 7166688100

Rajeswary, Jyotsna Internal Medicine Buffalo Geriatric & Rehabilitation Med 6400 Powers Rd Father Baker Manor Orchard Park NY 14127 Erie 7166670001

Rajeswary, Jyotsna Internal Medicine Buffalo Geriatric & Rehabilitation Med 3333 Elmwood Ave Schofield Residence Kenmore NY 14217 Erie 7168741566

Rajeswary, Jyotsna Internal Medicine Kaleida Health 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Rajeswary, Jyotsna Internal Medicine Buffalo Geriatric & Rehabilitation Med S4650 Southwestern Blvd Autumnview Manor Hamburg NY 14075 Erie 7166482450

Rasalingam, Maithridevi M. Internal Medicine Rasalingam, Maithridevi 725 Orchard Pk Rd Ste D West Seneca NY 14224 Erie 7166770038

Rimawi, Abdallah O. Internal Medicine Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Rimawi, Abdallah O. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166944500

Rimawi, Abdallah O. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Rm 8 632 Buffalo NY 14220 Erie 7166944500

Rimawi, Abdallah O. Internal Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Rodes, Alfredo M. Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Sachar, Rajinder S. Internal Medicine Cardiographic Associates 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912420

Sachar, Rajinder S. Internal Medicine Sachar, Rajinder S. 2848 William St Cheektowaga NY 14227 Erie 7168930900

Sachar, Rajinder S. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Santiano, Jesus A. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Santiano, Jesus A. Internal Medicine Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Shafi, Mohamad Internal Medicine Buffalo Kidney Associates, LLP 3435 Bailey Ave Buffalo NY 14215 Erie 7168358615

Shafi, Mohamad Internal Medicine Shafi, Mohamad 3469 Harlem Rd Cheektowaga NY 14225 Erie 7168360016

Shahid, Naveed Internal Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Shahid, Naveed Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Shahid, Naveed Internal Medicine Infinity Medical of WNY PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Shehata, Nady R. Internal Medicine Associated Physicians Of Western New York Pc 1616 Kensington Ave Buffalo NY 14215 Erie 7168353097

Shenoy, A S Narayana Internal Medicine Shenoy, A S Narayana 66 Weiss Ave West Seneca NY 14224 Erie 7166746612

Sheriff, Fuad H. Internal Medicine Amherst Medical Associates LLP 6000 N Bailey Ave Ste 1d Amherst NY 14226 Erie 7168344266

Siaw, Patrick A. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 1500 Broadway Buffalo NY 14212 Erie 7168938596

Siaw, Patrick A. Internal Medicine Elder Medical Services PC 2157 Main St Buffalo NY 14214 Erie 7168621984

Siaw, Patrick A. Internal Medicine Siaw, Patrick A. 86 Cheshire Ln East Amherst NY 14051 Erie 7168975285

Singh, Tajinder Pal Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 565 Abbott Rd Buffalo NY 14220 Erie 7166944500

Singla, Vikas Internal Medicine Genesee Valley Group Health Association Lifetime Health 120 Gardenville Parkway W. West Seneca NY 14224 Erie 7166683600

Smith, Matthew E. Internal Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301000

Page 56 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Smith, Matthew E. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Snyder, Brian D. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Snyder, Brian D. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Snyder, Brian D. Internal Medicine Buffalo Geriatric & Rehabilitation Med 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Snyder, Brian D. Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Snyder, Brian D. Internal Medicine Buffalo Geriatric & Rehabilitation Med S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Soh, Andrew Y. Internal Medicine Soh, Andrew 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710171

Somogyi, Ronald M. Internal Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166683000

Sood, Ritu Internal Medicine Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166683600

Sorrentino, Stephen P. Internal Medicine Endion Hospitalist of Western New York PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Sorrentino, Stephen P. Internal Medicine Albany Hospitalist PC dba Endion Hospitalist North 2605 Harlem Rd Buffalo NY 14225 Erie 7168912536

Soukiazian, Sevak Internal Medicine John A Brach MD PC DBA Buffalo Hospitali 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Soukiazian, Sevak Internal Medicine Buffalo Emergency Associates 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Soukiazian, Sevak Internal Medicine Buffalo Emergency Associates 2157 Main St Buffalo NY 14214 Erie 7168621000

Southard, Eric R. Internal Medicine Amherst Medical Associates LLP 6000 N Bailey Ave Ste 1d Amherst NY 14226 Erie 7168344266

Stehlik, Edward A. Internal Medicine Northtowns Medical Group 1540 Maple Rd Williamsville NY 14221 Erie 7166683600

Stehlik, Edward A. Internal Medicine Kenmore Physician Association 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476671

Stehlik, Edward A. Internal Medicine Northtowns Medical Group 2950 Elmwood Ave Kenmore NY 14223 Erie 7164476100

Stehlik, Edward A. Internal Medicine Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Stehlik, Edward A. Internal Medicine Northtowns Medical Group 1783 Colvin Blvd Buffalo NY 14223 Erie 7168742150

Stephen, James P. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 1500 Broadway Buffalo NY 14212 Erie 7168938550

Sulaiman, Adel S. Internal Medicine Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Sulaiman, Adel S. Internal Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Sy, Claude G. Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Tussing, Gordon P. Internal Medicine Tussing, Gordon 4643 Main St Snyder NY 14226 Erie 7168399113

Updike, Paul F. Internal Medicine Sisters of Charity Hospital : St Joseph Campus 1500 Broadway Buffalo NY 14212 Erie 7168938550

Varavenkataraman, Raghupathy Internal Medicine Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Vienne Jr, Richard P. Internal Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Warner, Andrew W. Internal Medicine Associated Physicians Of Western New York Pc 1616 Kensington Ave Buffalo NY 14215 Erie 7168353097

Warner, Andrew W. Internal Medicine Associated Physicians Of Western New York Pc 2805 Wehrle Dr Ste 10 Williamsville NY 14221 Erie 7166835252

Wen, Hongyu Internal Medicine Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301182

Whalen, Guy Michael Internal Medicine Southwestern Medical Associates 3675 Southwestern Blvd Orchard Park NY 14127 Erie 7169720279

Zakrzewski, Les A. Internal Medicine Zakrzewski, Les 721 Center Rd West Seneca NY 14224 Erie 7166774070

Zittel, Molly J. Internal Medicine Aurora Family Medical Health 530 Main St East Aurora NY 14052 Erie 7166525499

Zohur, Jamal B. Internal Medicine Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7169619400

Zulkharnain, Dr Internal Medicine Zulkharnain, - 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Chaudhry, Eram Interventional Cardiology Cardiovascular Care Services PLLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Chaudhry, Eram Interventional Cardiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Chaudhry, Eram Interventional Cardiology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621982

Chaudhry, Eram Interventional Cardiology Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Chaudhry, Eram Interventional Cardiology Medicor Associates Inc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Chaudhry, Eram Interventional Cardiology Cardiovascular Care Services PLLC 100 High St Buffalo NY 14203 Erie 7168595600

Conley, James G. Interventional Cardiology Cardiographic Associates 100 High St Buffalo NY 14203 Erie 7168592981

Conley, James G. Interventional Cardiology Conley, James 100 High St Buffalo NY 14203 Erie 7168592981

Corbelli, John C. Interventional Cardiology VA Western NY Health Med Ctr 3496 Bailey Ave Buffalo NY 14215 Erie 7172776323

Dashkoff, Neil Interventional Cardiology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Dashkoff, Neil Interventional Cardiology Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Dashkoff, Neil Interventional Cardiology Niagara Frontier Heart Assoc 20 Losson Rd Ste 100 Buffalo NY 14227 Erie 7166569825

Dashkoff, Neil Interventional Cardiology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Dashkoff, Neil Interventional Cardiology Niagara Frontier Heart Assoc 462 Grider St Buffalo NY 14215 Erie 7168941255

Emerson, Ronald P. Interventional Cardiology Empire Cardiology, PC 3065 Southwestern Blvd Ste 202 Orchard Park NY 14127 Erie 7166775866

Emerson, Ronald P. Interventional Cardiology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Emerson, Ronald P. Interventional Cardiology Empire Cardiology, PC 533 Niagara St Tonawanda NY 14150 Erie 7166775866

Furr, Charles M. Interventional Cardiology Medicor Associates Inc 826 Lake St Angola NY 14006 Erie 7165497777

Honore, Lesly S. Interventional Cardiology Endion Hospitalist of Western New York PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Iyer, Vijay S. Interventional Cardiology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592573

Iyer, Vijay S. Interventional Cardiology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Leonard Jr, Glenn T. Interventional Cardiology Pediatric Cardiology Associates 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Leonard Jr, Glenn T. Interventional Cardiology Pediatric Cardiology Associates 545 Abbott Rd Buffalo NY 14220 Erie 7168855437

Leonard Jr, Glenn T. Interventional Cardiology Pediatric Cardiology Associates 50 High St Buffalo NY 14203 Erie 7168855437

Leonard Jr, Glenn T. Interventional Cardiology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Leonard Jr, Glenn T. Interventional Cardiology Pediatric Cardiology Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7162044500

Leonard Jr, Glenn T. Interventional Cardiology Pediatric Cardiology Associates 936 Delaware Ave Ste 100 Buffalo NY 14209 Erie 7168855437

Leonard Jr, Glenn T. Interventional Cardiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Leonard Jr, Glenn T. Interventional Cardiology Pediatric Cardiology Associates 219 Bryant St Buffalo NY 14222 Erie 7168855437

Zlotnick, David M. Interventional Cardiology Cardiology Reading Panel LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page 57 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Zlotnick, David M. Interventional Cardiology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Zlotnick, David M. Interventional Cardiology Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Zlotnick, David M. Interventional Cardiology Cardiology Reading Panel LLC 100 High St Buffalo NY 14203 Erie 7168595600

Abrams, Linda A. Lic Clinical Social Work Abrams, Linda 162 Main St Hamburg NY 14075 Erie 7166672730

Akin, Denise M. Lic Clinical Social Work Akin, Denise M. 8265 Sheridan Dr Ste 107 Williamsville NY 14221 Erie 7163083507

Alessi, Joseph J. Lic Clinical Social Work Alessi, Joseph 142 Bidwell Pkwy Buffalo NY 14222 Erie 7168861142

Amra Williams, Rashida M. Lic Clinical Social Work Amra Williams, Rashida 5820 Main St Ste 205 Williamsville NY 14221 Erie 7169035676

Amra Williams, Rashida M. Lic Clinical Social Work EHS Inc DBA Evergreen Health Services 206 S Elmwood Ave Buffalo NY 14201 Erie 7168470315

Anger, Daniel W. Lic Clinical Social Work Anger, Daniel W. 1405 Sheridan Dr Ste 102 Kenmore NY 14217 Erie 7168378333

Antczak, Elisse M. Lic Clinical Social Work Antczak, Elisse 4140 Sheridan Dr Williamsville NY 14221 Erie 7162380829

Austin, Craig R. Lic Clinical Social Work Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Baglio, Beverly P. Lic Clinical Social Work Baglio, Beverly 2800 Sweethome Rd Ste 8 Amherst NY 14228 Erie 7164795304

Baker, Meredith S. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Bakowski, Marie L. Lic Clinical Social Work Marie L Bakowski 4711 Transit Rd Ste 3 Depew NY 14043 Erie 7167065921

Barcos, Jacqueline M. Lic Clinical Social Work Barcos, Jacqueline 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Baum, Wendy G. Lic Clinical Social Work Weny Gabel Baum 651 Delaware Ave Ste 211 Plaza Stes 149 Buffalo NY 14202 Erie 7163621206

Beckley-Forest, Ann M. Lic Clinical Social Work Beckley-Forest, Ann M. 2478 George Urban Blvd Depew NY 14043 Erie 7165532256

Beiter, Mary J. Lic Clinical Social Work Mary Beiter, LCSW 252 E Main St Springville NY 14141 Erie 7165929292

Beiter, Mary J. Lic Clinical Social Work Mary Beiter, LCSW 162 Main St Hamburg NY 14075 Erie 7165450314

Bennett, Elizabeth S. Lic Clinical Social Work Bennett, Elizabeth 11901 Broadway Ste 201 Alden NY 14004 Erie 7169373300

Bermingham, William M. Lic Clinical Social Work Western New York Medical 4979 Harlem Rd Ste 1 Amherst NY 14226 Erie 7169234380

Bermingham, William M. Lic Clinical Social Work Western New York Medical 4985 Harlem Rd Amherst NY 14226 Erie 7169234380

Bermingham, William M. Lic Clinical Social Work Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Bermingham, William M. Lic Clinical Social Work Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166481342

Bermingham, William M. Lic Clinical Social Work Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168222028

Bermingham, William M. Lic Clinical Social Work Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Bermingham, William M. Lic Clinical Social Work Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Bermingham, William M. Lic Clinical Social Work Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Bermingham, William M. Lic Clinical Social Work Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Biegner, Michelle W. Lic Clinical Social Work 2813 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7168687832

Bingham, Donna M. Lic Clinical Social Work Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Binner, Jeanne M. Lic Clinical Social Work Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168821025

Borenzweig, Elizabeth T. Lic Clinical Social Work Borenzweig, Elizabeth 2360 Sweet Home Rd Ste 4 Amherst NY 14228 Erie 7166321756

Borenzweig, Elizabeth T. Lic Clinical Social Work Borenzweig, Elizabeth 5780 Main St Buffalo NY 14221 Erie 7166321756

Brandt Douglas, Sarah B. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Brandt, Jean M. Lic Clinical Social Work Brandt, Jean M. 4476 Main St Ste 208 Buffalo NY 14226 Erie 7169494664

Brent, Thomas E. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Breny, Judith Lic Clinical Social Work Breny, Judith 51 Colonial Cir Lafayette Ave Entrance Buffalo NY 14222 Erie 7169082169

Breny, Judith Lic Clinical Social Work Breny, Judith 4476 Main St Ste 208 Amherst NY 14226 Erie 7169082169

Breny, Judith Lic Clinical Social Work Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Brigante, James A. Lic Clinical Social Work Brigante, James 5780 Main St Williamsville NY 14221 Erie 7166321860

Brimo, Marcella L. Lic Clinical Social Work Brimo, Marcella L. 4511 Harlem Rd Ste 14 Amherst NY 14226 Erie 7169129360

Brimo, Marcella L. Lic Clinical Social Work Brimo, Marcella L. 5580 Broadway Ste 4 Lancaster NY 14086 Erie 7169129360

Brown, Judith R. Lic Clinical Social Work Amici Behavioral Health LCSW PLLC 200 Woodward Ave Buffalo NY 14214 Erie 7168618061

Brown, Judith R. Lic Clinical Social Work Amici Behavioral Health LCSW PLLC 200 Woodward Ave Buffalo NY 14214 Erie 7168618061

Bruni, Roberta M. Lic Clinical Social Work 5100 Big Tree Rd Orchard Park NY 14127 Erie 7164818271

Bruni, Roberta M. Lic Clinical Social Work 4535 Southwestern Blvd Hamburg NY 14075 Erie 7166466075

Buhl, Marcia E. Lic Clinical Social Work Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Bunis, Ruthellen Lic Clinical Social Work Life Transitions Center 150 Bennett Rd Cheektowaga NY 14227 Erie 7168366460

Bunis, Ruthellen Lic Clinical Social Work Bunis, Ruthellen 5820 Main St Ste 203 Buffalo NY 14221 Erie 7169841883

Burgos, Holly M. Lic Clinical Social Work Holly M Burgos LCSW 7 Westgate Rd Kenmore NY 14217 Erie 7168731357

Bylewski, Christine M. Lic Clinical Social Work Bylewski, Christine 5166 Main St Ste 100 Williamsville NY 14221 Erie 7165652092

Caballero, Michael R. Lic Clinical Social Work Caballero, Michael 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Cady, Kathleen A. Lic Clinical Social Work Cady, Kathleen 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Cammarata, Frank A. Lic Clinical Social Work Cammarata, Frank 5586 Main St Ste G2 Buffalo NY 14221 Erie 7166307075

Campbell Vanremme, June Lic Clinical Social Work Campbell-Vanremme, June 4184 Seneca St Ste 208 West Seneca NY 14224 Erie 7166754962

Campbell, Marita Lic Clinical Social Work Campbell, Marita 8899 Main St Williamsville NY 14221 Erie 7166332120

Campbell, Marita Lic Clinical Social Work Campbell, Marita 406 Linwood Ave Buffalo NY 14209 Erie 7168867304

Cannavo, Joanne M. Lic Clinical Social Work Cannavo, Joanne 4511 Harlem Rd Ste 15 Amherst NY 14226 Erie 7168165147

Carli, Nike F. Lic Clinical Social Work Carli, Nike 5500 Main St Ste 207 Buffalo NY 14221 Erie 7166336900

Carpenter, Kathleen L. Lic Clinical Social Work Jennifer Erickson DO & Robert Erickson D 3671 Southwestern Blvd Ste 213 Orchard Park NY 14127 Erie 7166627008

Castillo, Kristina N. Lic Clinical Social Work Suburban Psychiatric Assoc 240 Redtail Dr Ste 7 8 Orchard Park NY 14127 Erie 7166893333

Catti, Susan M. Lic Clinical Social Work Catti, Susan 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Chapman Jr, Barry J. Lic Clinical Social Work Barry J Chapman Jr 1660 Hopkins Rd Ste 103 Getzville NY 14068 Erie 7166893110

Chisum, Lisa D. Lic Clinical Social Work Michael Wright 3729 Union Rd Cheektowaga NY 14225 Erie 7167830407

Chojnacki, Ann M. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Ste 704 Hamburg NY 14075 Erie 7166893333

Page 58 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Christman, Barbara J. Lic Clinical Social Work 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Clark, Grace I. Lic Clinical Social Work Grace I Clark 4711 Transit Rd Ste 3 Depew NY 14043 Erie 7167065921

Cline-Tarbell, Wendy Lic Clinical Social Work 166 Highland Dr Williamsville NY 14221 Erie 7166340847

Cline-Tarbell, Wendy Lic Clinical Social Work Cline-Tarbell, Wendy 2813 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7169089518

Coburn Kane, Annie Lic Clinical Social Work Coburn-Kane, Annie 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Coffta, Stephanie Lic Clinical Social Work Coffta, Stephanie 21 Linwood Ave Williamsville NY 14221 Erie 7166269016

Coffta, Stephanie Lic Clinical Social Work Coffta, Stephanie 11 Church St Akron NY 14001 Erie 7163641873

Coles, Carol A. Lic Clinical Social Work James L Coles Csw Pc 142 Bidwell Pkwy Buffalo NY 14222 Erie 7169128206

Coles, James L. Lic Clinical Social Work James L Coles Csw Pc 224 E Main St Springville NY 14141 Erie 7165928108

Coles, James L. Lic Clinical Social Work James L Coles Csw Pc 142 Bidwell Pkwy Buffalo NY 14222 Erie 7164725962

Conklin, Carol A. Lic Clinical Social Work Conklin, Carol 610 Ashland Ave Buffalo NY 14222 Erie 7168837713

Corsaro, Juliana Lic Clinical Social Work Hashim, Junaid 1275 Delaware Ave Ste 303 Buffalo NY 14209 Erie 7168865493

Cox, Sally A. Lic Clinical Social Work Cox, Sally 5820 Main St Ste 203 Williamsville NY 14221 Erie 7165651510

Craig, Patricia M. Lic Clinical Social Work Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Creighton, Carol J. Lic Clinical Social Work Creighton, Carol J. 1837 Hertel Ave Buffalo NY 14216 Erie 7168340990

Cullen, Thomas P. Lic Clinical Social Work Cullen, Thomas 4184 Seneca St Ste 208 West Seneca NY 14224 Erie 7166750038

Daniels, Barbara L. Lic Clinical Social Work Daniels, Barbara 5500 Main St Ste 349a Williamsville NY 14221 Erie 7166319788

Delgosha, Angelina Lic Clinical Social Work Delgosha, Angelina 3065 Southwestern Blvd Amherst NY 14226 Erie 7168376705

Delgosha, Angelina Lic Clinical Social Work Delgosha, Angelina 315 Alberta Dr Amherst NY 14226 Erie 7168376705

Dennis, Katherine A. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Buffalo NY 14228 Erie 7166893333

DeSimone, Lynn M. Lic Clinical Social Work Lynn DeSimone 5784 Main St Williamsville NY 14221 Erie 7168609174

Donahue, Stacey L. Lic Clinical Social Work Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Donahue, Stacey L. Lic Clinical Social Work Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Donahue, Stacey L. Lic Clinical Social Work Buffalo Spine Medicine and Rehab PLLC 770 Wehrle Dr Cheektowaga NY 14225 Erie 7166260093

Doyle, Daniel R. Lic Clinical Social Work Doyle, Daniel R 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Doyle, Daniel R. Lic Clinical Social Work Patricia Kelsey English Road Psychot 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Dreyer, Immacolata Lic Clinical Social Work Dreyer, Immacolata 300 Center Rd Ste 1 Buffalo NY 14224 Erie 7164300704

Edson, Mark W. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Edson, Mark W. Lic Clinical Social Work Edson, Mark W. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Edwards, Colleen Lic Clinical Social Work Colleen Edwards 2341 Bowen Rd Elma NY 14059 Erie 7168638627

Edwards, Colleen Lic Clinical Social Work Colleen Edwards 2111 Girdle Rd Elma NY 14059 Erie 7166523000

Egan, Patricia Lic Clinical Social Work Egan, Patricia 21 Linwood Ave Williamsville NY 14221 Erie 7166269016

Einarsson, Jennifer M. Lic Clinical Social Work Einarsson, Jennifer M. 3625 Eggert Rd Ste 204 Orchard Park NY 14127 Erie 7166682228

Epstein, Jane E. Lic Clinical Social Work Kaleida Health 3020 Bailey Ave Buffalo NY 14215 Erie 7168311800

Epstein, Jane E. Lic Clinical Social Work Horizon Health Services 1370 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168333708

Evola, Michael A. Lic Clinical Social Work Evola, Michael 5500 Main St Ste 349 Buffalo NY 14221 Erie 7166341184

Evola, Michael A. Lic Clinical Social Work Evola, Michael 406 Linwood Ave Buffalo NY 14209 Erie 7168867304

Falgiano, Ceaton C. Lic Clinical Social Work Falgiano, Ceaton C. 6265 Sheridan Ste 122 Williamsville NY 14221 Erie 7162045552

Falgiano, Ceaton C. Lic Clinical Social Work Suburban Psychiatric Assoc 240 Red Tail Ste 7 and 8 Orchard Park NY 14127 Erie 7166893333

Falk, Ursula A. Lic Clinical Social Work Falk, Ursula 1197 Kenmore Ave Kenmore NY 14217 Erie 7168735400

Fanara, Charmaine A. Lic Clinical Social Work Michael Wright 3729 Union Rd Cheektowaga NY 14225 Erie 7167830407

Fanara, Charmaine A. Lic Clinical Social Work Michael Wright 361 Niagara St Tonawanda NY 14150 Erie 7167830407

Fanara, Charmaine A. Lic Clinical Social Work Michael Wright 4429 Union Rd Cheektowaga NY 14225 Erie 7168730407

Feinberg, Monika L. Lic Clinical Social Work 4476 Main St Amherst NY 14226 Erie 7168330415

Fitzgerald, Sarah E. Lic Clinical Social Work Alden Counseling & Wellness LLC 11901 Broadway St Alden NY 14004 Erie 7169373300

Fowler, Charles L. Lic Clinical Social Work Fowler, Charles L. 1207 Delaware Ave Ste 210 Buffalo NY 14209 Erie 7168708342

Fowler, Charles L. Lic Clinical Social Work Hashim, Junaid 1825 Maple Rd Ste 200 Williamsville NY 14221 Erie 7168865493

Fowler, Charles L. Lic Clinical Social Work Fowler, Charles L. 8899 Main St Williamsville NY 14221 Erie 7168708342

Fowler, Charles L. Lic Clinical Social Work Fowler, Charles L. 1131 Kensington Ave Buffalo NY 14215 Erie 7168708342

Fowler, Sheryl A. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Frasca, Lucy Lic Clinical Social Work Frasca, Lucy 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Friedman, Janice F. Lic Clinical Social Work Friedman, Janice 5500 Main St Ste 207 Buffalo NY 14221 Erie 7166336900

Frigon, Christopher A. Lic Clinical Social Work Kaleida Health 3020 Bailey Ave Buffalo NY 14215 Erie 7168311800

Fronczak, Thomas Lic Clinical Social Work Thomas Fronczak 4476 Main St Ste 208 Amherst NY 14226 Erie 4014312953

Fronczak, Thomas Lic Clinical Social Work EHS Inc DBA Evergreen Health Services 206 S Elmwood Ave Buffalo NY 14201 Erie 7168470315

Frost, Glenn W. Lic Clinical Social Work Frost, Glenn 3980 Sheridan Dr Amherst NY 14226 Erie 7164179998

Fuller, Denise R. Lic Clinical Social Work Fuller, Denise R. 8201 Main St Ste 2 Williamsville NY 14221 Erie 7162768320

Gargala, Jean M. Lic Clinical Social Work Gargala, Jean M. 4955 N Bailey Ave Ste 214 Amherst NY 14226 Erie 7164177752

Geary, Elizabeth M. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Geary, Elizabeth M. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Amherst NY 14226 Erie 7166890040

Geary, Elizabeth M. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Gee, Scott A. Lic Clinical Social Work Gee, Scott 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Gee, Scott A. Lic Clinical Social Work Jayne Kiel Associates 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Gee, Scott A. Lic Clinical Social Work Jayne Kiel Associates 467 Virginia St Buffalo NY 14202 Erie 7168550880

Genco, Elizabeth M. Lic Clinical Social Work Genco, Elizabeth 100 Corporate Pkwy Ste 318 Amherst NY 14226 Erie 7167838292

Genco, Elizabeth M. Lic Clinical Social Work Genco, Elizabeth 11861 Broadway Alden NY 14004 Erie 7169376893

Page 59 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Gerwitz-Hirschfelt, Maureen D. Lic Clinical Social Work Gerwitz-Hirschfelt, Maureen D. 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Gerwitz-Hirschfelt, Maureen D. Lic Clinical Social Work Gerwitz-Hirschfelt, Maureen D. 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Gevirtzman, Paul H. Lic Clinical Social Work Gevirtzman, Paul 197 Brinton St Buffalo NY 14216 Erie 7168330415

Gianadda, Diane M. Lic Clinical Social Work Gianadda, Diane 1520 E Delavan Ave Buffalo NY 14215 Erie 7168930931

Giancarlo, Eileen M. Lic Clinical Social Work Giancarlo, Eileen 1631 Hertel Ave Buffalo NY 14216 Erie 7168338800

Giancarlo, Eileen M. Lic Clinical Social Work Giancarlo, Eileen 835 Hopkins Rd Buffalo NY 14221 Erie 7166880500

Giannino, Edward N. Lic Clinical Social Work Suburban Psychiatric Assoc 240 Red Tail Ste 7 8 Orchard Park NY 14127 Erie 7166893333

Giannino, Edward N. Lic Clinical Social Work Giannino, Edward 280 Baynes St Buffalo NY 14213 Erie 7168811152

Gillen, Patricia Lic Clinical Social Work Patricia Gillen 4511 Harlem Rd Amherst NY 14226 Erie 9143382635

Gillen, Patricia Lic Clinical Social Work Patricia Gillen 5580 Broadway Lancaster NY 14086 Erie 9143382635

Gostomski, Beverly J. Lic Clinical Social Work Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Gottlieb Sass, Wendy J. Lic Clinical Social Work Gottlieb-Sass, Wendy 406 Linwood Ave Buffalo NY 14209 Erie 7168867304

Grande, James F. Lic Clinical Social Work Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Grande, James F. Lic Clinical Social Work Life Transitions Center 150 Bennett Rd Cheektowaga NY 14227 Erie 7168366460

Grande, James F. Lic Clinical Social Work Life Transitions Center 1140 Delaware Ave Buffalo NY 14222 Erie 7163325900

Grant, Ellen E. Lic Clinical Social Work Grant, Ellen E. 1300 Niagara St Buffalo NY 14213 Erie 7163086328

Gray, David F. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Griesmann, Carol E. Lic Clinical Social Work Transit Psychiatry 4721 Transit Rd Ste 23 Lancaster NY 14043 Erie 7167065921

Griesmann, Carol E. Lic Clinical Social Work Transit Psychiatry 4476 Main St Amherst NY 14226 Erie 7164350050

Griffin, Gregory D. Lic Clinical Social Work Griffin Counseling Services 154 Main St Ste 7 Hamburg NY 14075 Erie 7163200166

Groeger, Gregory F. Lic Clinical Social Work Elizabeth Pierce Olmsted MD Center for the Visually Imp 1170 Main St Buffalo NY 14209 Erie 7168821025

Groeger, Gregory F. Lic Clinical Social Work Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168821025

Grube, Laura Lic Clinical Social Work Laura Grube 5500 Main St Ste 207 Amherst NY 14221 Erie 7166336900

Gruppuso, Erica L. Lic Clinical Social Work Erica L Gruppuso 2478 George Urban Blvd Depew NY 14043 Erie 7165480383

Gulino, Constance A. Lic Clinical Social Work Gulino, Constance 162 Main St Hamburg NY 14075 Erie 7162281329

Haase-Smith, Julie A. Lic Clinical Social Work Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Hakes, Dolores Lic Clinical Social Work Hakes, Dolores 4774 Union Rd Buffalo NY 14225 Erie 7167439117

Hakes, Dolores Lic Clinical Social Work Hakes, Dolores 965 Delaware Ave Buffalo NY 14209 Erie 7167439117

Hakes, Dolores Lic Clinical Social Work Hakes, Dolores S 6065 S Park Ave Hamburg NY 14075 Erie 7167439117

Halker, Mackenzie A. Lic Clinical Social Work Halker, Mackenzie A. 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Harris Moran, Roberta Lic Clinical Social Work Harris-Moran, Roberta 1837 Hertel Ave Buffalo NY 14216 Erie 7168345114

Harrison, Ronjonette N. Lic Clinical Social Work HEART Community Alliance 1131 Kensington Ave Buffalo NY 14215 Erie 7168340080

Harrison, Ronjonette N. Lic Clinical Social Work Ronjonette N Harrison 3165 Bailey Ave Ste 2 Buffalo NY 14215 Erie 7164746293

Henry, Jen E. Lic Clinical Social Work Henry, Jen E. 5784 Main St Williamsville NY 14221 Erie 7166336863

Hilburger, Jill D. Lic Clinical Social Work Hilburger, Jill D. 4184 Seneca St Ste 208 West Seneca NY 14224 Erie 7168677070

Houghton, Doris D. Lic Clinical Social Work Kaleida Health 3020 Bailey Ave Buffalo NY 14215 Erie 7168311800

Huels, Darryl J. Lic Clinical Social Work Huels, Darryl J 3859 N Buffalo St Orchard Park NY 14127 Erie 7164811472

Huels, Darryl J. Lic Clinical Social Work Huels, Darryl J 520 Seneca Creek Rd West Seneca NY 14224 Erie 7164811472

Hughes, Pamela M. Lic Clinical Social Work Hughes, Pamela M. 350 Greenhaven Ter Tonawanda NY 14150 Erie 7162601538

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 1150 Youngs Rd Williamsville NY 14221 Erie 7168840230

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 3075 Southwestern Blvd Ste 208 Orchard Park NY 14127 Erie 7167120490

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 4845 Transit Rd Depew NY 14043 Erie 7168840230

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 3560 N Buffalo St Orchard Park NY 14127 Erie 7166628510

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 3950 E Robinson Rd Amherst NY 14228 Erie 7166913400

Hughes, Sharon B. Lic Clinical Social Work General Physician PC 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Hungerford, LaReine F. Lic Clinical Social Work Hungerford, LaReine 415 Ashland Ave Buffalo NY 14222 Erie 7168812296

Jackson, Cynthia A. Lic Clinical Social Work Jackson, Cynthia 6680 Main St Williamsville NY 14221 Erie 7166319212

Janik, Alysia A. Lic Clinical Social Work Alysia A Janik 21 Linwood Ave Buffalo NY 14221 Erie 7164721799

Jarecki, Kirsten L. Lic Clinical Social Work Jarecki, Kirsten 552 Linden Ave East Aurora NY 14052 Erie 7169132832

Jillian, Ruthanne Lic Clinical Social Work Jillian, Ruthanne 28 Dale Dr Tonawanda NY 14150 Erie 7166944618

John Banach, Brenda K. Lic Clinical Social Work Kaleida Health 3020 Bailey Ave Buffalo NY 14215 Erie 7168311800

Johnson, Michael P. Lic Clinical Social Work General Physician PC 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Johnson, Michael P. Lic Clinical Social Work General Physician PC 1150 Youngs Rd Williamsville NY 14221 Erie 7168840230

Johnson, Michael P. Lic Clinical Social Work General Physician PC 3950 E Robinson Rd Amherst NY 14228 Erie 7166913400

Johnson, Michael P. Lic Clinical Social Work General Physician PC 3075 Southwestern Blvd Orchard Park NY 14127 Erie 7167120490

Johnson, Michael P. Lic Clinical Social Work General Physician PC 3560 N Buffalo St Orchard Park NY 14127 Erie 7166628510

Johnson, Michael P. Lic Clinical Social Work General Physician PC 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Jones Clavell, Mary L. Lic Clinical Social Work HEART Community Alliance 1131 Kensington Ave Buffalo NY 14215 Erie 7168340080

Jones Clavell, Mary L. Lic Clinical Social Work Jones-Clavell, Mary 76 Laurentian Dr Cheektowaga NY 14225 Erie 7168975499

Jones, Patricia A. Lic Clinical Social Work Jones, Patricia 377 Main St Upper East Aurora NY 14052 Erie 7168057995

Jost, Matthew A. Lic Clinical Social Work Jost, Matthew 55 Huntington Ave Buffalo NY 14214 Erie 7168320089

Kelly, Jacalyn P. Lic Clinical Social Work Kelly, Jacalyn 300 Center Rd West Seneca NY 14224 Erie 7164710864

Kelly, Jerry S. Lic Clinical Social Work Jerry S Kelly 162 Main St Hamburg NY 14075 Erie 7165234630

Kelly, Jerry S. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 704 Hamburg NY 14075 Erie 7166893333

Keogh, Andrew M. Lic Clinical Social Work Keogh, Andrew 21 Linwood Ave Williamsville NY 14221 Erie 7166269016

Page 60 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kijowski, Christopher E. Lic Clinical Social Work Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Kijowski, Christopher E. Lic Clinical Social Work Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Kijowski, Christopher E. Lic Clinical Social Work Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

King Sedwick, Martha L. Lic Clinical Social Work Community Concern of WNY Inc 6722 Erie Rd Derby NY 14047 Erie 7169475025

King Sedwick, Martha L. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 704 Hamburg NY 14075 Erie 7166893333

Knab, Helen C. Lic Clinical Social Work Knab, Helen 4140 Sheridan Dr Ste 6 Williamsville NY 14221 Erie 7164003424

Koch, Diana C. Lic Clinical Social Work Diana C Koch 5580 Broadway Lancaster NY 14086 Erie 7163167232

Koeppel, Elaine Lic Clinical Social Work Koeppel, Elaine 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Komroy, Phyllis A. Lic Clinical Social Work Komroy, Phyllis 5166 Main St Ste 100 Williamsville NY 14221 Erie 7165652092

Koprevich, Mary E. Lic Clinical Social Work Koprevich, Mary 2680 Grand Island Blvd Grand Island NY 14072 Erie 7165737026

Kramer, Julie C. Lic Clinical Social Work Kramer, Julie C. 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Kramer, Julie C. Lic Clinical Social Work Kramer, Julie C. 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Kranock, Mary E. Lic Clinical Social Work Kranock, Mary 467 Virginia St Buffalo NY 14202 Erie 7168550880

Kranock, Mary E. Lic Clinical Social Work Jayne Kiel Associates 467 Virginia St Buffalo NY 14202 Erie 7168550880

Kropelin, Holly E. Lic Clinical Social Work Kropelin, Holly E. 3625 Eggert Rd Ste 204 Orchard Park NY 14127 Erie 7166622228

Labin, Corina M. Lic Clinical Social Work Michael Wright 361 Niagara St Tonawanda NY 14150 Erie 7167830407

Labin, Corina M. Lic Clinical Social Work Michael Wright 3729 Union Rd Cheektowaga NY 14225 Erie 7167830407

LaFalce, Lynette M. Lic Clinical Social Work Thompson, Laura J. 4255 Harlem Rd Amherst NY 14226 Erie 7162454415

LaPorta, Laurie J. Lic Clinical Social Work LaPorta, Laurie 162 Main St Hamburg NY 14075 Erie 7165975890

Leising, Peter C. Lic Clinical Social Work Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Leising, Peter C. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Lieber, Jill A. Lic Clinical Social Work Lieber, Jill 2430 N Forest Rd Ste 140 Getzville NY 14068 Erie 7166885372

Maiorana, Kathy A. Lic Clinical Social Work Maiorana, Kathy 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Maiorana, Kathy A. Lic Clinical Social Work Maiorana, Kathy 5780 Main St Williamsville NY 14221 Erie 7166321756

Makar, Julie A. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Malachowski, Norina Lic Clinical Social Work Hamburg Counseling Service 97 S Buffalo St Hamburg NY 14075 Erie 7166480650

Maloney, Juliet J. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy Buffalo NY 14224 Erie 7166683600

Maloney, Juliet J. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Maloney, Juliet J. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Maloney, Juliet J. Lic Clinical Social Work Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Marschner, Frederick Lic Clinical Social Work Marschner, Frederick 344 Niagara Falls Blvd Tonawanda NY 14223 Erie 7166980196

Marschner, Frederick Lic Clinical Social Work Marschner, Frederick 4248 Ridge Lea Rd Ste 12 Amherst NY 14226 Erie 7166980196

Martina, Nancy J. Lic Clinical Social Work Nancy Martina 5784 Main St Williamsville NY 14221 Erie 7166336863

Mazourek, Shirley B. Lic Clinical Social Work Mazourek, Shirley 4476 Main St Ste 208 Amherst NY 14226 Erie 7166285296

McCaffery, Judy L. Lic Clinical Social Work McCaffery, Judy 8265 Sheridan Dr Ste 107 Buffalo NY 14221 Erie 5857355068

McNally, George B. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

McNally, George B. Lic Clinical Social Work VA Western NY Health Med Ctr 3620 Harlem Rd Ste 10 Buffalo NY 14215 Erie 7168337425

McNally, George B. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

McNally, George B. Lic Clinical Social Work McNally, George 3620 Harlem Rd Ste 10 Cheektowaga NY 14215 Erie 7168337425

Meisner, Karin A. Lic Clinical Social Work 3859 N Buffalo Rd Ste 7 Orchard Park NY 14127 Erie 7169982088

Merritt, Patricia A. Lic Clinical Social Work Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Messer, Elizabeth S. Lic Clinical Social Work Electronic Gaming Therapy 8616 Main St Ste 4 Williamsville NY 14221 Erie 7169619435

Metzger, Ellen K. Lic Clinical Social Work Metzger, Ellen 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Michaels, Lana M. Lic Clinical Social Work Michaels, Lana 142 Bidwell Pkwy Buffalo NY 14222 Erie 7168705565

Miller, Sophia F. Lic Clinical Social Work Suburban Psychiatric Assoc 240 Red Tail Ste 7 and 8 Orchard Park NY 14127 Erie 7166893333

Miller, Sophia F. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryants Woods S Buffalo NY 14228 Erie 7166893333

Monaco, Anna J. Lic Clinical Social Work Monaco, Anna 99 Tristan Ln Buffalo NY 14221 Erie 7162892037

Monaco, Anna J. Lic Clinical Social Work Monaco, Anna 4955 N Bailey Ave Ste 214 Buffalo NY 14221 Erie 7162892037

Monaco, Joseph J. Lic Clinical Social Work Monaco, Joseph J. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Monda, Linda A. Lic Clinical Social Work HEART Community Alliance 1131 Kensington Ave Buffalo NY 14215 Erie 7168340080

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 462 Grider St Buffalo NY 14215 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 100 Stahl Rd Getzville NY 14068 Erie 7168107330

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 150 Bennett Rd Cheektowaga NY 14227 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Montz, Sara Lic Clinical Social Work Palliative Care Physicians Group PLLC 1014 Deleware Ave Buffalo NY 14209 Erie 7168836782

Motyka, Theresa M. Lic Clinical Social Work Motyka, Theresa 8899 Main St Williamsville NY 14221 Erie 7164741349

Moyer, Linda K. Lic Clinical Social Work Linda Kathleen Moyer 2478 George Urban Blvd Depew NY 14043 Erie 7163800238

Mueller, Linda S. Lic Clinical Social Work Mueller, Linda 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Murray, Anne W. Lic Clinical Social Work Anne W Murray LCSW PLLC 4511 Harlem Rd Ste 1 Buffalo NY 14226 Erie 7168615928

Myers, Pamela A. Lic Clinical Social Work University Psychiatric Practice Inc 4955 N Bailey Ave Ste 130 Amherst NY 14226 Erie 7168351246

Page 61 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Nixon, Mary J. Lic Clinical Social Work Nixon, Mary 4476 Main St Ste 208 Buffalo NY 14226 Erie 7165976178

Nixon, Mary J. Lic Clinical Social Work Nixon, Mary 27 Delaware Rd Kenmore NY 14217 Erie 7165976178

Nobel, Nicole E. Lic Clinical Social Work Nobel, Nicole 5500 Main St Ste 308 Williamsville NY 14221 Erie 7166261245

Norton, Daniel V. Lic Clinical Social Work Daniel V Norton 3625 Eggert Rd Ste 204 Orchard Park NY 14127 Erie 7168121568

Norton, Daniel V. Lic Clinical Social Work Daniel V Norton 5820 Main St Ste 308 Williamsville NY 14221 Erie 7168121568

Novotny, Lewis J. Lic Clinical Social Work Woodbridge Counseling LCSW PC 6161 Transit Rd Ste 4 East Amherst NY 14051 Erie 7165722365

Nuessle, Doreen S. Lic Clinical Social Work Nuessle, Doreen 300 Center Rd West Seneca NY 14224 Erie 7163610541

Nuessle, Gregg A. Lic Clinical Social Work Nuessle, Gregg A. 3959 N Buffalo St Orchard Park NY 14127 Erie 7162350930

O Brien, Mark F. Lic Clinical Social Work Mark O'Brien LCSW 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Olandese, Michelle L. Lic Clinical Social Work Michelle L Olandese 2813 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7165660920

Oldfield Jr, William R. Lic Clinical Social Work Oldfield, William 3620 Harlem Rd Ste 7 Buffalo NY 14215 Erie 7168382811

Owens, Thomas J. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Pauley, Tammy C. Lic Clinical Social Work Pauley, Tammy C. 3533 N Buffalo Rd Orchard Park NY 14127 Erie 7166624283

Pauley, Tammy C. Lic Clinical Social Work Pauley, Tammy C. 584 E Main St Springville NY 14141 Erie 7165924286

Pauley, Tammy C. Lic Clinical Social Work Pauley, Tammy C. 8097 Center Rd Holland NY 14080 Erie 7169415727

Pawlowski, Theresa A. Lic Clinical Social Work Pawlowski, Theresa A. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Pawlowski, Theresa A. Lic Clinical Social Work Pawlowski, Theresa A. 162 Main St Hamburg NY 14075 Erie 7168688010

Pawlowski, Theresa A. Lic Clinical Social Work Pawlowski, Theresa A. 3648 Seneca St West Seneca NY 14224 Erie 7162563729

Pay, Tracey E. Lic Clinical Social Work Pay, Tracey E. 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Pay, Tracey E. Lic Clinical Social Work Pay, Tracey E. 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Perak, John J. Lic Clinical Social Work John J Perak 315 Alberta Dr Ste 21 Amherst NY 14226 Erie 7168376705

Perreault, Lora L. Lic Clinical Social Work Perrault, Lora L. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Peter Sebian, Lorraine C. Lic Clinical Social Work Peter-Sebian, Lorraine C. 5144 Sheridan Dr Ste 100 Buffalo NY 14221 Erie 7165480990

Peter Sebian, Lorraine C. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Peter Tabone, Carol A. Lic Clinical Social Work Peter-Tabone, Carol 5144 Sheridan Dr Buffalo NY 14221 Erie 7162048697

Petersen Cleary, Mary Beth Lic Clinical Social Work Levy, Harold 2740 Main St Buffalo NY 14214 Erie 7168373990

Pisaro, Kathleen E. Lic Clinical Social Work Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Pisaro, Kathleen E. Lic Clinical Social Work Pisaro, Kathleen 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Piwko, Sandra A. Lic Clinical Social Work Thompson, Laura J. 4255 Harlem Rd Amherst NY 14226 Erie 7162411565

Popson, Karen B. Lic Clinical Social Work Community Concern of WNY Inc 265 Union St Ste 104 Hamburg NY 14075 Erie 7166485262

Popson, Karen B. Lic Clinical Social Work Karen B Popson CSW 265 Union St Ste 104 Hamburg NY 14075 Erie 7166485262

Popson, Richard D. Lic Clinical Social Work Community Concern of WNY Inc 6722 Erie Rd Derby NY 14047 Erie 7169475025

Popson, Richard D. Lic Clinical Social Work Popson, Richard 265 Union St Ste 104 Hamburg NY 14075 Erie 7166485262

Przynosch, Jennifer A. Lic Clinical Social Work Jennifer A Przynosch 6265 Sheridan Dr Ste 122 Williamsville NY 14221 Erie 7162045552

Redell, Kristin M. Lic Clinical Social Work Redell, Kristin M. 4255 Harlem Rd Amherst NY 14226 Erie 7169080560

Richards, Alma B. Lic Clinical Social Work Richards, Alma 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Ring, Mary M. Lic Clinical Social Work Ring, Mary 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Rizzo, Rosalina B. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Rosenthal, Alice M. Lic Clinical Social Work Rosenthal, Alice 4511 Harlem Rd Ste 14 Snyder NY 14226 Erie 7168332299

Rosinski, Julie M. Lic Clinical Social Work Kaleida Health 3020 Bailey Ave Buffalo NY 14215 Erie 7168311800

Ruhl-Terrana, Ella M. Lic Clinical Social Work Levy, Harold 2740 Main St Buffalo NY 14214 Erie 7165537653

Ruhl-Terrana, Ella M. Lic Clinical Social Work Ella Terrana 2813 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7166331280

Rusk, James Lic Clinical Social Work Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Ruth, Irma K. Lic Clinical Social Work Ruth, Willard 1801 Grand Island Blvd Ste 300 Grand Island NY 14072 Erie 7167736181

Ryan-Heiser, Amy C. Lic Clinical Social Work Amy C Ryan-Heiser LCSW 2813 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7169089363

Sadkin, Wendy F. Lic Clinical Social Work Sadkin, Wendy 315 Alberta Dr Ste 211 Buffalo NY 14226 Erie 7168376705

Schoen, Jillian E. Lic Clinical Social Work Schoen, Jillian 2732 Main St Office Ste 7 Buffalo NY 14214 Erie 7166336900

Schoen, Jillian E. Lic Clinical Social Work Schoen, Jillian 5500 Main St Ste 207 Williamsville NY 14214 Erie 7166336900

Schoenwetter, Michael J. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Schoenwetter, Michael J. Lic Clinical Social Work Michael J Schoenwetter 4511 Harlem Rd Ste 2 Snyder NY 14226 Erie 7162626934

Schoenwetter, Michael J. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Schwartz, Carolann Lic Clinical Social Work Schwartz, Carolann 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Schwenkbeck, Jennifer M. Lic Clinical Social Work Schwenkbeck, Jennifer M. 229 Main St 2nd Fl Hamburg NY 14075 Erie 7162381236

Schwenkbeck, Jennifer M. Lic Clinical Social Work Schwenkbeck, Jennifer M. 100 E Main St Hamburg NY 14075 Erie 7166464991

Scibetta, Joseph B. Lic Clinical Social Work Ruth, Willard 1801 GRAND ISLAND BLVD Grand Island NY 14072 Erie 7167736181

Scibetta, Joseph B. Lic Clinical Social Work Scibetta, Joseph 142 Bidwell Pkwy Buffalo NY 14222 Erie 7168864492

Scibetta, Joseph B. Lic Clinical Social Work Scibetta, Joseph 1801 Grand Is Blvd Grand Island NY 14072 Erie 7167736181

Scibetta, Joseph B. Lic Clinical Social Work Ruth, Willard 142 Bidwell Pkwy Buffalo NY 14222 Erie 7168864492

Scozzaro, Christopher Lic Clinical Social Work Christopher Scozzaro 3859 N Buffalo Rd Orchard Park NY 14127 Erie 7166752032

Shannon, Kathleen Lic Clinical Social Work General Physician PC 3950 E Robinson Rd Amherst NY 14228 Erie 7166913400

Shannon, Kathleen Lic Clinical Social Work General Physician PC 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Shannon, Kathleen Lic Clinical Social Work General Physician PC 4845 Transit Rd Depew NY 14043 Erie 7168840230

Shannon, Kathleen Lic Clinical Social Work General Physician PC 3075 Southwestern Blvd Orchard Park NY 14127 Erie 7167120490

Shannon, Kathleen Lic Clinical Social Work General Physician PC 1150 Youngs Rd Williamsville NY 14221 Erie 7166367979

Shannon, Kathleen Lic Clinical Social Work General Physician PC 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Shannon, Kathleen Lic Clinical Social Work General Physician PC 3560 N Buffalo St Orchard Park NY 14127 Erie 7166628510

Page 62 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Shear Jr, John C. Lic Clinical Social Work John C Shear 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Silver, Ellen J. Lic Clinical Social Work Silver, Ellen 3802 Seneca St Buffalo NY 14224 Erie 7166775418

Silver, Ellen J. Lic Clinical Social Work Silver, Ellen 4476 Main St Ste 208 Amherst NY 14226 Erie 7166775418

Skelton, Nancy J. Lic Clinical Social Work Skelton, Nancy J. 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Skelton, Nancy J. Lic Clinical Social Work Skelton, Nancy J. 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Slammon, Kathleen M. Lic Clinical Social Work Slammon, Kathleen 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Sleight, Lucia L. Lic Clinical Social Work Sleight, Lucia 154 Lexington Ave Buffalo NY 14222 Erie 7168334882

Smith, Sarah A. Lic Clinical Social Work Suburban Psychiatric Assoc 240 Red Tail Ste 7 and 8 Orchard Park NY 14127 Erie 7166893333

Smith, Sarah A. Lic Clinical Social Work Smith, Sarah A. 100 Corporate Pkwy Ste 318 Amherst NY 14226 Erie 7167838292

Smythe, Katherine L. Lic Clinical Social Work Ahmed & Ahmed Physicians PC 8207 Main St Ste 7 and 8 Williamsville NY 14221 Erie 7166264200

Snyder, Leah M. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 704 Hamburg NY 14075 Erie 7166893333

Somit, Nancy Lic Clinical Social Work Somit, Nancy 936 Delaware Ave Ste 403 Buffalo NY 14202 Erie 7168821034

Spengler, Daniel A. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Stewart, Reed C. Lic Clinical Social Work Reed C Stewart 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Stromberg, Joanne R. Lic Clinical Social Work Joanne Stromberg 5500 Main St Ste 308 Williamsville NY 14221 Erie 7166341184

Strychasz, Joseph W. Lic Clinical Social Work Strychasz, Joseph 160 Monmouth Ave Tonawanda NY 14150 Erie 7168332330

Strychasz, Joseph W. Lic Clinical Social Work Strychasz, Joseph 4476 Main St Ste 208 Buffalo NY 14226 Erie 7168332330

Suarez, Concepcion Lic Clinical Social Work C S Licensed Master Social Work Services 4053 Maple Rd Ste 110 Amherst NY 14226 Erie 7165786963

Suarez, Concepcion Lic Clinical Social Work C S Licensed Master Social Work Services 8600 Sheridan Dr Ste 1 Williamsville NY 14221 Erie 7165786963

Suarez, Concepcion Lic Clinical Social Work Suarez, Concepcion 2714 Sheridan Dr 2nd Fl Tonawanda NY 14150 Erie 6467967554

Sullivan, Richard M. Lic Clinical Social Work Sullivan, Richard 5420 Shimerville Rd Clarence NY 14031 Erie 7167412138

Sullivan, Richard M. Lic Clinical Social Work Sullivan, Richard 8899 Main St Williamsville NY 14221 Erie 7167412138

Swift, Susan S. Lic Clinical Social Work Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Tasman, Debra L. Lic Clinical Social Work Tasman, Debra 5780 Main St Buffalo NY 14221 Erie 7169408554

Thomas, Maryjean Lic Clinical Social Work M Jean Thomas LCSW, PLLC 484 Main St East Aurora NY 14052 Erie 7166554022

Toth, Andre Lic Clinical Social Work Toth, Andre 5820 Main St Ste 313 Buffalo NY 14221 Erie 7164458343

Trimboli Burgio, Rosemary Lic Clinical Social Work Trimboli-Burgio, Rosemary 8899 Main St Buffalo NY 14221 Erie 7168707002

Trimboli Burgio, Rosemary Lic Clinical Social Work Trimboli-Burgio, Rosemary 85 Bryant Woods S Buffalo NY 14228 Erie 7166893333

Trimboli Burgio, Rosemary Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Buffalo NY 14228 Erie 7166893333

Urban, Jennifer M. Lic Clinical Social Work Urban, Jennifer M. 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Urban, Jennifer M. Lic Clinical Social Work Urban, Jennifer M. 1360 N Forest Rd Ste 102 Williamsville NY 14221 Erie 7164354320

Vande Velde, Jennifer A. Lic Clinical Social Work Jennifer Vande Velde LCSW PC 4955 N Bailey Ave Ste 214 Amherst NY 14226 Erie 7162137116

Vander Kooy, Edo G. Lic Clinical Social Work Hashim, Junaid 1825 Maple Rd Ste 200 Williamsville NY 14221 Erie 7168865493

Walker, Dawn M. Lic Clinical Social Work Dawn M. Walker, LCSW PLLC 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Washington, Kendra P. Lic Clinical Social Work KPW Licensed Clinical Social Work Services, PC 3729 Union Rd Ste 6 Cheektowaga NY 14225 Erie 7169828092

Washington, Kendra P. Lic Clinical Social Work CHC of Buffalo INC 34 Benwood Ave Buffalo NY 14214 Erie 7169869199

Wasiura, Karen L. Lic Clinical Social Work Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Watson, Alease Lic Clinical Social Work Alease Watson 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 1503 Military Rd Kenmore NY 14217 Erie 7164476600

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 292 Main St East Aurora NY 14052 Erie 7166521560

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 1205 Delaware Ave Buffalo NY 14209 Erie 7168853838

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 1175 Delaware Ave Buffalo NY 14209 Erie 7168856733

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 6060 Armor Rd Orchard Park NY 14127 Erie 7166624433

Weber, Jennifer A. Lic Clinical Social Work CHE Senior Psychological Service 4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Weinberg, Julie D. Lic Clinical Social Work 6507 Transit Rd Ste B East Amherst NY 14051 Erie 7163930789

Weinstein, Susan Lic Clinical Social Work Weinstein, Susan 406 Linwood Ave Buffalo NY 14209 Erie 7168867304

West, Ellen S. Lic Clinical Social Work Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Whitcomb, Jennelle R. Lic Clinical Social Work Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Woike Ganga, Elizabeth M. Lic Clinical Social Work 21 Linwood Ave Buffalo NY 14221 Erie 7166269016

Wolasz, Nicole E. Lic Clinical Social Work Wolasz, Nicole E. 2478 George Urban Blvd Depew NY 14043 Erie 7162288205

Wolf, Barbara W. Lic Clinical Social Work Kaleida Health 3020 Bailey Ave Buffalo NY 14215 Erie 7168311800

Wolf, Barbara W. Lic Clinical Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Wolfrum, Barbara A. Lic Clinical Social Work Wolfrum, Barbara 984 Backus Rd Derby NY 14047 Erie 7165491139

Wooding, Gail W. Lic Clinical Social Work Wooding, Gail W. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Work, Kenneth J. Lic Clinical Social Work Work, Kenneth J. 8600 Sheridan Dr Williamsville NY 14221 Erie 7165786963

Work, Kenneth J. Lic Clinical Social Work Work, Kenneth J. 4053 Maple Rd Ste 110 Amherst NY 14226 Erie 7165786963

Wray, Marilyn B. Lic Clinical Social Work Marilyn B Wray 1914 Colvin Blvd Tonawanda NY 14150 Erie 7165107644

Wright, Michael F. Lic Clinical Social Work Hashim, Junaid 1825 Maple Rd Ste 200 Williamsville NY 14221 Erie 7168865493

Wright, Michael F. Lic Clinical Social Work Wright, Michael 3729 Union Road Cheektowaga NY 14225 Erie 7167830407

Wright, Michael F. Lic Clinical Social Work Michael Wright 3729 Union Rd Cheektowaga NY 14225 Erie 7167830407

Wright, Susan D. Lic Clinical Social Work Wright, Susan 5820 Main St Ste 203 Buffalo NY 14221 Erie 7165651510

Yeager, Susan F. Lic Clinical Social Work Yeager, Susan 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Zander, Nancy Lic Clinical Social Work Zander, Nancy 4407 S Buffalo St Orchard Park NY 14127 Erie 7167774700

Page 63 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Zannoni, Joseph P. Lic Clinical Social Work Zannoni, Joseph 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Zannoni, Joseph P. Lic Clinical Social Work Zannoni, Joseph 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Inthanonsak, Jim K. Lic Master Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Scardina, Andrew C. Lic Master Social Work VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Vantine, Monica Lic Master Social Work VA Western NY Health Med Ctr 227 Ridge Rd Buffalo NY 14218 Erie 7172776565

Achkar, Tammy L. Massage Therapy Achkar, Tammy 3648 Seneca St West Seneca NY 14224 Erie 7167711354

Amborski, Beverly A. Massage Therapy 9146 Main St Clarence NY 14031 Erie 7169390365

Ardary Smith, Angela N. Massage Therapy Ardary-Smith, Angela N. 4928 Broadway Depew NY 14043 Erie 7168301706

Ardary Smith, Angela N. Massage Therapy Ardary-Smith, Angela N. 5411 Sheridan Dr Williamsville NY 14221 Erie 7168301706

Armstrong, Kenneth J. Massage Therapy 5324 Rogers Rd Hamburg NY 14075 Erie 7166496851

Bailor Goodlander, Christine Massage Therapy 5225 Sheridan Dr Williamsville NY 14221 Erie 7166264466

Banaszak, Mark Massage Therapy Banaszak, Mark 398 A Evans St Williamsville NY 14221 Erie 7168649079

Banaszak, Mark Massage Therapy Banaszak, Mark 6321 Balsam Fir Ct Clarence Center NY 14032 Erie 7168649079

Bergmann, Beth A. Massage Therapy Bergmann, Beth A. 5225 Sheridan Dr Body Essential Williamsville NY 14221 Erie 7166264466

Biegasiewicz, Rodney C. Massage Therapy Martino, Jennifer 181 Allen St Buffalo NY 14201 Erie 7168700420

Booth, Shannon B. Massage Therapy Mind Body and Sole Massage Therapy 5586 Main St Ste 202 Williamsville NY 14221 Erie 7162454325

Brainard, Donna Massage Therapy Brainard, Donna 658 Main St East Aurora NY 14052 Erie 5855350518

Bridges, Donna E. Massage Therapy 3320 N Benzing Rd Orchard Park NY 14127 Erie 7168307511

Burse, Ramona Massage Therapy Burse, Ramona 2871 Genesee St Cheektowaga NY 14225 Erie 7168635142

Caligiuri, Karen A. Massage Therapy Caligiuri, Karen 1900 Ridge Rd West Seneca NY 14224 Erie 7166772969

Campanile, Leah K. Massage Therapy Therapy LLC 558 Oakwood Ave East Aurora NY 14052 Erie 7164452780

Campbell, Teresa A. Massage Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166311516

Campbell, Teresa A. Massage Therapy Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Ste 300 Derby NY 14047 Erie 7169470139

Cappola, Patrick Massage Therapy Massage Therapeutic Arts 160 North St Buffalo NY 14201 Erie 7168851581

Conrad, Shirley A. Massage Therapy Conrad, Shirley 4211 N Buffalo Rd Barrington Professional Ctr Orchard Park NY 14127 Erie 7168662826

Conrad, Shirley A. Massage Therapy Conrad, Shirley 4211 N Buffalo St Ste 8 Orchard Park NY 14127 Erie 7168662826

Corcimiglia, Debra J. Massage Therapy Corcimiglia, Debra 535 W Main St Springville NY 14141 Erie 7165609884

Crocker Jr, Danial J. Massage Therapy Millard, Valerie 295 E Main St Ste 740 Buffalo NY 14203 Erie 7168544555

Dahlin, Amy J. Massage Therapy 350 Alberta Dr Ste 204 Buffalo NY 14226 Erie 7167044769

DiBartolomeo, Erika Massage Therapy DiBartolomeo, Erika Lancaster Depew Chiropractic 345 Dick Rd Depew NY 14043 Erie 7166813333

Dickinson, Jennifer L. Massage Therapy Dickinson, Jennifer 3407 Delaware Ave Kenmore NY 14217 Erie 7164461244

Dojnik, Karin L. Massage Therapy Dojnik, Karin 4974 Transit Rd Depew NY 14043 Erie 7168617052

Dojnik, Karin L. Massage Therapy Dojnik, Karin 8600 Main St Ste 2 Buffalo NY 14221 Erie 7168617052

Dojnik, Karin L. Massage Therapy Dojnik, Karin 462 Grider St Buffalo NY 14215 Erie 7168617052

Dojnik, Karin L. Massage Therapy Dojnik, Karin 1380 French Rd Depew NY 14043 Erie 7168617052

Elwell, Sharon E. Massage Therapy 2430 Bowen Rd Elma NY 14059 Erie 7169979020

Ensminger, Becky Massage Therapy Ensminger, Becky 345 Dick Rd Depew NY 14043 Erie 7166813333

Esposito, Sarah A. Massage Therapy Mundion, Sarah A. 160 North St Buffalo NY 14201 Erie 7168851581

Felicetta, Erika L. Massage Therapy Felicetta, Erika 167 Ashland Ave Buffalo NY 14222 Erie 7164009444

Fiegl, Susan C. Massage Therapy Fiegl, Susan C. 9366 Transit Rd East Amherst NY 14051 Erie 7166393791

Flanigan, Danielle K. Massage Therapy 90 Hamburg St East Aurora NY 14052 Erie 7166552533

Forti, Cathleen M. Massage Therapy 3383 Big Tree Rd Hamburg NY 14075 Erie 7169806107

Found, Marilyn J. Massage Therapy Marils Hands 3518 Southwestern Blvd Orchard Park NY 14127 Erie 7169510432

Gajewski, Stephanie M. Massage Therapy Elle Therapeutic Massage PC 1909 Union Rd West Seneca NY 14224 Erie 7166753380

Gasiewicz, Marcy Massage Therapy 767 Mineral Springs Rd West Seneca NY 14224 Erie 7168231343

Giovannucci, Gerald Massage Therapy Martino, Jennifer 181 Allen St Buffalo NY 14201 Erie 7168700240

Gleason, Eleanor M. Massage Therapy Living Well Massage Therapy LLP 2122 Eggert Rd Living Well Massage Therapy LLP Amherst NY 14226 Erie 7168346001

Glover, Joy C. Massage Therapy Elle Therapeutic Massage PC 1909 Union Rd West Seneca NY 14224 Erie 7166753380

Grant, Brittany J. Massage Therapy 295 Main St Ste 740 Buffalo NY 14203 Erie 7165103942

Grey, Debora Massage Therapy Grey, Debora 3435 Harlem Rd Ste 7 Cheektowaga NY 14225 Erie 7164798298

Grzankowski, Elaine A. Massage Therapy Grzankowski, Elaine Lower Lvl 6810 Main St Williamsville NY 14221 Erie 7166329406

Hanlon, Susan A. Massage Therapy Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621386

Hornburg, Rebecca L. Massage Therapy Honor and Hope Welllness Center 38 Lake St Hamburg NY 14075 Erie 7166499004

Jarvis, Monique M. Massage Therapy Massage Suite and Spa Inc 989 Kenmore Ave Buffalo NY 14217 Erie 7168772728

Jaworski, Alicia M. Massage Therapy Jaworski, Alicia M. 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7164321288

Jayakumar, Shanthy Massage Therapy Harisa Massage Therapy PC 466 Niagara Falls Blvd Buffalo NY 14223 Erie 7168320058

Jemiolo, Holly Massage Therapy Jemiolo, Holly 4721 Transit Rd Depew NY 14043 Erie 7166682225

Jemiolo, Holly Massage Therapy Jemiolo, Holly 2577 Sheridan Dr Tonawanda NY 14150 Erie 7168328888

Johnson, Maralynn Massage Therapy Johnson, Maralynn 3525 Seneca St West Seneca NY 14224 Erie 7165536483

Jones Ring, Susan F. Massage Therapy Jones Ring, Susan 4390 Quinby Dr Ste E Hamburg NY 14075 Erie 7169136759

Jones Ring, Susan F. Massage Therapy Jones Ring, Susan 5451 Allen Dr Hamburg NY 14075 Erie 7169136759

Jones, Paul A. Massage Therapy Jones, Paul A. 350 Alberta Dr Ste 204 Buffalo NY 14226 Erie 7165360799

Jones, Paul A. Massage Therapy Jones, Paul A. 1598 Hertel Ave Buffalo NY 14216 Erie 7165630799

Kaiser, Erica J. Massage Therapy Kaiser, Erica J. 2448 Union Rd Cheektowaga NY 14227 Erie 7166560200

Keesler, Christy Massage Therapy Lancaster Depew Chiropractic 345 Dick Rd Depew NY 14043 Erie 7166813333

Kimball, David R. Massage Therapy Ellicott Square Chiropractic PLLC 295 Main St Ste 118 Buffalo NY 14203 Erie 7168522696

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kimball, David R. Massage Therapy Kimball, David 1400 Sweethome Rd Ste 3 Amherst NY 14228 Erie 7168641563

Koch, Chrystal L. Massage Therapy 704 Beach St Cheektowaga NY 14225 Erie 7163353162

Lane, Wendy V. Massage Therapy Wendy V. Lane, LMT 5225 Sheridan Dr Williamsville NY 14221 Erie 7166264466

Lane, Wendy V. Massage Therapy Wendy V. Lane, LMT 3435 Harlem Rd Carson Pl Ste 8 Cheektowaga NY 14225 Erie 7166564077

Langheier, Deborah L. Massage Therapy 21 Buffalo St Hamburg NY 14075 Erie 7166971578

Leadbetter, Lauren Massage Therapy Leadbetter, Lauren 542 Quaker Rd East Aurora NY 14052 Erie 7162040785

Leadbetter, Lauren Massage Therapy Leadbetter, Lauren 154 Plaza Dr Williamsville NY 14221 Erie 7162040785

Lindell, Jill M. Massage Therapy Lindell, Jill 928 French Rd Cheektowaga NY 14227 Erie 7166688021

Lovallo, Deborah M. Massage Therapy Balance Massage and Wellness 295 Main St Ellicott Sq Bldg Buffalo NY 14203 Erie 7168643678

Lukitsch, Melissa A. Massage Therapy Lukitsch, Melissa 1620 Southwestern Blvd West Seneca NY 14224 Erie 7165923808

Mariacher, Lisa M. Massage Therapy 1088 Brighton Rd Tonawanda NY 14150 Erie 7168678777

Mariacher, Lisa M. Massage Therapy 3685 Harlem Rd Buffalo NY 14215 Erie 7168678777

Marino, Cassandra A. Massage Therapy 5600 Broadway Ave Lancaster NY 14086 Erie 7168305993

Markowski, Laurie A. Massage Therapy Markowski, Laurie A. 3685 Southwestern Blvd Orchard Park NY 14127 Erie 7166620906

Martino, Jennifer Massage Therapy Martino, Jennifer 181 Allen St Buffalo NY 14201 Erie 7168700240

Masterson, Mary B. Massage Therapy Masterson, Mary 33 Longmeadow Dr East Aurora NY 14052 Erie 7166522644

Mathewson, Lorri Massage Therapy Mathewson, Lorri 8180 Wehrle Dr Williamsville NY 14221 Erie 7166324246

Meech, Jane Massage Therapy Meech, Jane 4201 N Buffalo Rd Orchard Park NY 14127 Erie 7166622713

Millard, Valerie E. Massage Therapy Millard, Valerie 295 Main St Ste 740 Buffalo NY 14203 Erie 7168544555

Minniefield, Rachel L. Massage Therapy Minniefield, Rachel L. 4565 Clark St Hamburg NY 14075 Erie 7165988500

Miori, Michelle M. Massage Therapy Miori, Michelle M. 13500 Broadway St Alden NY 14004 Erie 7163807153

Moran Jr, Nathan P. Massage Therapy 5861 Transit Rd East Amherst NY 14051 Erie 7166889299

Morrella, Tracy L. Massage Therapy The Cuttage Salon and Spa Inc 6929 Erie Rd Derby NY 14047 Erie 7169479028

Nicholas, Wolfanger C. Massage Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166311516

Nowak, James C. Massage Therapy 229 Lake St Hamburg NY 14075 Erie 7168880456

O Donnell, Katherine M. Massage Therapy O'Donnell, Katherine M. 450 Central Ave Ste A Lancaster NY 14086 Erie 7166835012

Oar, Dana I. Massage Therapy Millard, Valerie 295 Main St Ste 740 Buffalo NY 14203 Erie 7168544555

Ordon, Janice Massage Therapy Ordon, Janice 4917 William St Ste A and B Lancaster NY 14086 Erie 7167060005

Orffeo, Andres Massage Therapy Living Well Massage Therapy LLP 2122 Eggert Rd Amherst NY 14226 Erie 7168346001

Orffeo, Ann Massage Therapy Living Well Massage Therapy LLP 2122 Eggert Rd Amherst NY 14226 Erie 7168346001

Oryszak, Lisa Massage Therapy 154 Cazenovia St Buffalo NY 14210 Erie 7168662066

Perlette Dossett, Jennifer L. Massage Therapy 767 Mineral Springs Rd West Seneca NY 14224 Erie 7168231343

Plewa, Alysia T. Massage Therapy Plewa, Alysia 90 Hamburg St East Aurora NY 14052 Erie 7166552533

Quesenberry, Elizabeth M. Massage Therapy The Cuttage Salon and Spa Inc 6929 Erie Rd Derby NY 14047 Erie 7165494209

Quinn, Kristin L. Massage Therapy Quinn, Kristin L. 2437 Berg Rd West Seneca NY 14224 Erie 7169121208

Raczka, Mary A. Massage Therapy Uplinger, Mary 1045 Union Rd West Seneca NY 14224 Erie 7164445654

Raczka, Mary A. Massage Therapy Uplinger, Mary 486 Walnut Ave Angola NY 14006 Erie 7164445654

Randles, Lori Massage Therapy 160 North St Buffalo NY 14201 Erie 7168851581

Refermat, Patricia D. Massage Therapy Honor and Hope Wellness Ctr 38 Lake St Hamburg NY 14075 Erie 7166499004

Regan, Kathleen Massage Therapy Massage Therapeutic Arts 313 Elmwood Ave Buffalo NY 14222 Erie 7168851581

Reich, Kerry C. Massage Therapy Reich, Kerry 5859 Transit Rd East Amherst NY 14051 Erie 7166881768

Reich, Kerry C. Massage Therapy Reich, Kerry 5897 S Park Ave Hamburg NY 14075 Erie 7164457851

Rogers, Hope Massage Therapy Plewa, Alysia 90 Hamburg St East Aurora NY 14052 Erie 7166552533

Russell, Jennifer C. Massage Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166311516

Russo, Tami L. Massage Therapy Russo, Tami 33 Gates Cir Ste 1A Buffalo NY 14209 Erie 7168079738

Samuel, Brenda L. Massage Therapy Samuel, Brenda L. 4000 Main St Amherst NY 14226 Erie 7164620053

Sawynsky, Jennifer Q. Massage Therapy Martino, Jennifer 181 Allen St Buffalo NY 14201 Erie 7168700240

Sayles, Susan J. Massage Therapy 229 Main St Hamburg NY 14075 Erie 7164915882

Sayles, Susan J. Massage Therapy 5324 Rogers Rd Hamburg NY 14075 Erie 7166496851

Schaner, Janice W. Massage Therapy 3370 Walden Ave Ste 110 Depew NY 14043 Erie 7166037304

Schichtel, Elizabeth A. Massage Therapy 1967 Wehrle Dr Ste 12 Williamsville NY 14221 Erie 7164001860

Schummer, Jennifer M. Massage Therapy Schummer, Jennifer 5353 Main St Williamsville NY 14221 Erie 7167254218

Schummer, Jennifer M. Massage Therapy Schummer, Jennifer 1301 N Forest Rd Williamsville NY 14221 Erie 7166310954

Silverman, Eric J. Massage Therapy Silverman, Eric J. 5225 Sheridan Dr Williamsville NY 14221 Erie 7164809430

Sneed, Lizzie C. Massage Therapy Lizzie Sneed, LMT 2696 Sheridan Dr Lower Right Tonawanda NY 14150 Erie 7162289843

Spors, Linda R. Massage Therapy Linda Spors, LMT 7269 Saint Francis Dr Hamburg NY 14075 Erie 7166273668

Spors, Linda R. Massage Therapy Linda Spors, LMT 271 Main St Springville NY 14141 Erie 7166552533

Stabler, Sarah G. Massage Therapy 1961 Wherle Dr Ste 7 Williamsville NY 14221 Erie 7168165740

Stachowiak, Sara E. Massage Therapy Stachowiak, Sara E. 3868 E Robinson Rd Amherst NY 14228 Erie 7169121281

Stoos, Andrea K. Massage Therapy Stoos, Andrea K. 231 Aurora St Lancaster NY 14086 Erie 7167135607

Sullivan, Susan M. Massage Therapy 5225 Sheridan Dr Williamsville NY 14221 Erie 7166264466

Swiatkowski, Christy Massage Therapy Swiatkowski, Christy LMT 1598 Hertel Ave Buffalo NY 14216 Erie 7165535118

Synrod, Marie Massage Therapy Synrod, Marie 5336 Broadway St Lancaster NY 14086 Erie 7166811099

Tombak, Danielle M. Massage Therapy Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621386

Townsend, Steven R. Massage Therapy Townsend, Steven 56 E Main St Springville NY 14141 Erie 7165925425

Twardowski, Robert W. Massage Therapy Twardowski, Robert 3316 Sheridan Dr Amherst NY 14226 Erie 7168330024

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Ulrich, Sandy J. Massage Therapy Ulrich, Sandy 162 Main St 2nd Fl Hamburg NY 14075 Erie 7166274704

Varco, Terrie A. Massage Therapy Advanced Body Care 5132 Transit Rd Depew NY 14043 Erie 7166810071

Wagner, Pamala Massage Therapy 2577 Sheridan Dr Tonawanda NY 14150 Erie 7164323217

Wagner, Pamala Massage Therapy 3045 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7167130464

Will, Heidi J. Massage Therapy Eurospa by Veronika 326 Cayuga Rd Buffalo NY 14225 Erie 7166327373

Will, Heidi J. Massage Therapy Russo, Tami 33 Gates Cir Ste 1A Buffalo NY 14209 Erie 7168852872

Williams, Pamela S. Massage Therapy Williams, Pamela S. 2300 George Urban Blvd Ste 1 Depew NY 14043 Erie 7168120303

Williams, Valencia R. Massage Therapy Williams, Valencia R. 210 Central Ave Lancaster NY 14086 Erie 7166818610

Williams, Valencia R. Massage Therapy Williams, Valencia R. 4214 Clinton St West Seneca NY 14224 Erie 7166752255

Williams, Valencia R. Massage Therapy Living Well Massage Therapy LLP 2122 Eggert Rd Ste 1 Buffalo NY 14226 Erie 7168346001

Williams, Valencia R. Massage Therapy Williams, Valencia R. 245 Hastings Ave Buffalo NY 14215 Erie 7168332673

Williams, Valencia R. Massage Therapy Advanced Body Care 5132 Transit Rd Depew NY 14043 Erie 7166810071

Wojewoda, Sara J. Massage Therapy 3370 Walden Ave Depew NY 14043 Erie 7163807380

Yaple, Amy S. Massage Therapy Yaple, Amy 154 Plaza Dr Williamsville NY 14221 Erie 7164801766

Yaple, Amy S. Massage Therapy Yaple, Amy 3868 E Robinson Rd Amherst NY 14228 Erie 7164801766

Zimmerman, Roger J. Massage Therapy Zimmerman, Roger 1967 Wehrle Dr Ste 12 Williamsville NY 14221 Erie 7164792171

Zinter, Susan R. Massage Therapy Zinter, Susan R. 1801 Grand Island Blvd Grand Island NY 14072 Erie 7164814737

Zinter, Susan R. Massage Therapy Zinter, Susan R. 2463 Bush Rd Grand Island NY 14072 Erie 7164814737

Adams, Lan L. Maternal and Fetal Med Mercy Hospital 515 Abbott Rd Ste 204 Buffalo NY 14220 Erie 7168283650

Adams, Lan L. Maternal and Fetal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Adams, Lan L. Maternal and Fetal Med Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Bolnick, Jay M. Maternal and Fetal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Bolnick, Jay M. Maternal and Fetal Med OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Bolnick, Jay M. Maternal and Fetal Med OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Bolnick, Jay M. Maternal and Fetal Med Kaleida Health 239 Bryant St WCHOB Perinatal Clinic Buffalo NY 14222 Erie 7168781227

Bolnick, Jay M. Maternal and Fetal Med Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Bolnick, Jay M. Maternal and Fetal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Chandra, Prasanta C. Maternal and Fetal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Giannina, Gregg Maternal and Fetal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Giannina, Gregg Maternal and Fetal Med Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168781227

Giannina, Gregg Maternal and Fetal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Jacobson, Sig Linda Maternal and Fetal Med Kaleida Health 219 Bryant St Buffalo NY 142222006 Erie 7168787000

Jacobson, Sig Linda Maternal and Fetal Med Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168781227

Jacobson, Sig Linda Maternal and Fetal Med Mercy Hospital 515 Abbott Rd Ste 204 Buffalo NY 14220 Erie 7168283650

Johnson, Jeffrey R. Maternal and Fetal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Johnson, Jeffrey R. Maternal and Fetal Med Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168781227

Johnson, Jeffrey R. Maternal and Fetal Med University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Johnson, Jeffrey R. Maternal and Fetal Med University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Johnson, Jeffrey R. Maternal and Fetal Med University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Rodgers, Bruce D. Maternal and Fetal Med Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

White, Laurel M. Maternal and Fetal Med White, Laurel 136 Maple Rd Amherst NY 14221 Erie 7166328124

Adjei, Alex Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ahmed, Mohamed S. Medical Oncology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Berenji, Farid Medical Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Boland, Patrick M. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Chary, Kandala K. Medical Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Chary, Kandala K. Medical Oncology Century Medical Associates 45 Spindrift Dr Ste 100 Buffalo NY 14221 Erie 7165650355

Chen, George L. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Chen, Hongbin Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Conway, James T. Medical Oncology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168983000

Conway, James T. Medical Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301039

Czuczman, Myron S. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Dhillon, Jaspreet Medical Oncology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Dougherty, David R. Medical Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301045

Dougherty, David R. Medical Oncology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168983000

Dougherty, David R. Medical Oncology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301045

Duvivier, Herbert L. Medical Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Duvivier, Herbert L. Medical Oncology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14224 Erie 7166744006

Early, Amy P. Medical Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301029

Early, Amy P. Medical Oncology Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168985698

Early, Amy P. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical 100 College Pkwy Ste 290 Williamsville NY 14221 Erie 7168458711

Early, Amy P. Medical Oncology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168985698

Early, Amy P. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Garbes, Isosceles D. Medical Oncology Garbes, Isosceles D. 3612 Seneca St West Seneca NY 14224 Erie 7166743104

George, Saby Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Gill, Liveleen M. Medical Oncology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14224 Erie 7166744006

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Gill, Liveleen M. Medical Oncology Gill, Liveleen 725 Orchard Pk Rd Ste C West Seneca NY 14224 Erie 7166744006

Hernandez Ilizaliturri, Francisco J. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Hong, Frederick Medical Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Hong, Frederick Medical Oncology Century Medical Associates 45 Spindrift Dr Ste 100 Buffalo NY 14221 Erie 7165650355

Islam, Abul Medical Oncology Sheehan Memorial Hospital B6 100 High St Buffalo NY 14203 Erie 7168592360

Iyer, Renuka V. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Kanj, Ola S A. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14203 Erie 7168452300

Khushalani, Nikhil I. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kotowski, Adam S. Medical Oncology RPCI Oncology PC 199 Park Club Ln Ste 200 Williamsville NY 14221 Erie 7166343340

Krabak, Michael J. Medical Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Lee, Kelvin P. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Levine, Ellis G. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Logue, Gerald L. Medical Oncology Academic Medicine Services 462 GRIDER ST Buffalo NY 14215 Erie 7168983000

Logue, Gerald L. Medical Oncology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Ma, Wen W. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Malhotra, Usha Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

McCarthy Jr, Philip L. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

O Connor, Tracey L. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Ontiveros, Evelena Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Opyrchal, Mateusz Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Pili, Roberto Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Romanowski, Roslyn R. Medical Oncology Academic Medicine Services 3980 Sheridan Dr Amherst NY 14226 Erie 7169619900

Romanowski, Roslyn R. Medical Oncology Century Medical Associates 45 Spindrift Dr Ste 100 Buffalo NY 14221 Erie 7165650355

Romanowski, Roslyn R. Medical Oncology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ross, Maureen Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Snyderman, Michael C. Medical Oncology Snyderman, Michael 515 Abbott Rd Ste 102 Buffalo NY 14220 Erie 7168245588

Soh, Andrew Y. Medical Oncology Soh, Andrew 2950 Elmwood Ave Buffalo NY 14217 Erie 7168710171

Soniwala, Saifuddin Medical Oncology RPCI Oncology PC 199 Park Club Ln Ste 200 Williamsville NY 14221 Erie 7166343340

Sood, Raman Medical Oncology CCS Medical PLLC dba Century Medical Associates 45 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7165650355

Sood, Raman Medical Oncology CCS Medical PLLC dba Century Medical Associates 725 Orchard Park Rd Ste C West Seneca NY 14224 Erie 7166744006

Trump, Donald L. Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Wetzler, Meir Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Yosuico, Victor E. Medical Oncology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578752

Yosuico, Victor E. Medical Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7168578752

Yosuico, Victor E. Medical Oncology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168985698

Zhao, Yujie Medical Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Zielinski, Robert M. Medical Oncology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168983000

Zielinski, Robert M. Medical Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301059

Joshi, Prashant Medical Toxicology University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Joshi, Prashant Medical Toxicology University at Buffalo Pediatric Associates Inc PO Box 2113 Buffalo NY 14222 Erie 7168781570

Joshi, Prashant Medical Toxicology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787442

Deeb, George Molecular Genetic Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Nowak, David E. Molecular Genetic Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Albert, George P. Neonatal - Perinatal Med Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Berkelhamer, Sara K. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Berkelhamer, Sara K. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7168787673

Bommaraju, Mahesh Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Bommaraju, Mahesh Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Bommaraju, Mahesh Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Carrion, Vivien Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Carrion, Vivien Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Carrion, Vivien Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Carrion, Vivien Neonatal - Perinatal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787673

Dukarm, Robert C. Neonatal - Perinatal Med Buffalo Neonatology Associates 2157 Main St Buffalo NY 14214 Erie 7166344798

Dukarm, Robert C. Neonatal - Perinatal Med Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621271

Dukarm, Robert C. Neonatal - Perinatal Med Mercy Hospital 525 Abbott Rd Buffalo NY 14220 Erie 7168282775

Dukarm, Robert C. Neonatal - Perinatal Med Mercy Hospital 565 Abbott Rd Buffalo NY 14210 Erie 7168267000

Dukarm, Robert C. Neonatal - Perinatal Med Buffalo Neonatology Associates 565 Abbott Rd Buffalo NY 14220 Erie 7166344798

Elberson, Valerie D. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Elberson, Valerie D. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7168787673

Handa, Deepali Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Handa, Deepali Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Kumar, Vasantha H. Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7168787675

Kumar, Vasantha H. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Kumar, Vasantha H. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Lakshminrush, Satyanarayan Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page 67 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lakshminrush, Satyanarayan Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Lakshminrush, Satyanarayan Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Leach, Corinne L. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Leach, Corinne L. Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Leach, Corinne L. Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Mathew, Bobby Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Mathew, Bobby Neonatal - Perinatal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Mathew, Bobby Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Mathew, Bobby Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Nair, Jayasree Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Nair, Jayasree Neonatal - Perinatal Med Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Nair, Jayasree Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Reynolds, Anne Marie Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Reynolds, Anne Marie Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Reynolds, Anne Marie Neonatal - Perinatal Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787673

Riley, Thomas F. Neonatal - Perinatal Med Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Riley, Thomas F. Neonatal - Perinatal Med Mercy Hospital 565 Abbott Rd Buffalo NY 14227 Erie 7166013600

Riley, Thomas F. Neonatal - Perinatal Med Buffalo Neonatology Associates 2157 Main St Buffalo NY 14214 Erie 7166344798

Singhal, Kamal K. Neonatal - Perinatal Med Buffalo Neonatology Associates 565 Abbott Rd Buffalo NY 14220 Erie 7166344798

Singhal, Kamal K. Neonatal - Perinatal Med Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Wynn, Ralph J. Neonatal - Perinatal Med Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Abebe, Mekdess A. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Abebe, Mekdess A. Nephrology Nephrology Associates of Western NY LLP 220 Redtail Pkwy Ste 2 Orchard Park NY 14127 Erie 7168383188

Ali, Basharat Nephrology Ali, Basharat 3218 Walden Ave Depew NY 14043 Erie 7166843500

Ali, Basharat Nephrology Ali, Basharat 2949 Elmwood Ave Buffalo NY 14217 Erie 7168737301

Ali, Basharat Nephrology Ali, Basharat 1045 Wehrle Dr Buffalo NY 14221 Erie 7166881464

Arora, Pradeep Nephrology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Bent Shaw, Luis Alfredo N. Nephrology Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Bent Shaw, Luis Alfredo N. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983152

Bhatnagar, Jyotsna Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984119

Bhatnagar, Jyotsna Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983100

Cunningham, Eugene E. Nephrology Eugene E Cunningham MD 550 Orchard Park Rd West Seneca NY 14224 Erie 7166776200

Cunningham, Eugene E. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Cunningham, Eugene E. Nephrology Min, Inkee 550 ORCHARD PARK RD STE A103 West Seneca NY 14224 Erie 7166770089

Cunningham, Eugene E. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984803

Cunningham, Eugene E. Nephrology Liberty RC Inc 550 Orchard Pk Rd Buffalo NY 14224 Erie 7166770089

Dasari, Jayaprakash R. Nephrology Kidney and Hypertension Physician PC 2095 Kensington Ave Buffalo NY 14226 Erie 7166500373

Dasari, Jayaprakash R. Nephrology Kidney and Hypertension Physician PC 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166500373

Del Castillo, Maria C. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Del Castillo, Maria C. Nephrology Nephrology Associates of Western NY LLP 3801 Taylor Rd Orchard Park NY 14127 Erie 7162090105

Del Castillo, Maria C. Nephrology Nephrology Associates of Western NY LLP 220 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7167120864

Farry, James K. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Farry, James K. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984803

Gundroo, Aijaz A. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Gundroo, Aijaz A. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984803

Hom, Jennie Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983375

Hom, Jennie Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983375

Khan, Saleem A. Nephrology Buffalo Kidney Associates, LLP 3435 Bailey Ave Buffalo NY 14215 Erie 7168358615

Kohli, Romesh K. Nephrology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578613

Kuritzky, Alan S. Nephrology Nephrology Associates of Western NY LLP 3801 Taylor Rd Orchard Park NY 14127 Erie 7162090105

Kuritzky, Alan S. Nephrology Nephrology Associates of Western NY LLP 220 Redtail Ste 2 Orchard Park NY 14127 Erie 7167120864

Kuritzky, Alan S. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Levine, Michael I. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Levine, Michael I. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984803

Lohr, James W. Nephrology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Lohr, James W. Nephrology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Mahran, Khalid S. Nephrology Kidney Care PC 2121 Main St Ste 216 Buffalo NY 14214 Erie 7168331511

Marinides, George N. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Marinides, George N. Nephrology Nephrology Associates of Western NY LLP 220 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7167120864

Matteson, Kristin A. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Matteson, Kristin A. Nephrology Nephrology Associates of Western NY LLP 220 Red Tail Ste 2 Orchard Park NY 14127 Erie 7167120864

Min, Inkee Nephrology Min, Inkee 85 High St Buffalo NY 14203 Erie 7168578614

Min, Inkee Nephrology Liberty RC Inc 550 Orchard Pk Rd West Seneca NY 14224 Erie 7166770089

Min, Inkee Nephrology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578614

Murray, Brian M. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984803

Namassivaya, Arundathi Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Page 68 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Namassivaya, Arundathi Nephrology Nephrology Associates of Western NY LLP 220 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7167120864

Panesar, Mandip Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Panesar, Mandip Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984803

Pankewycz, Oleh G. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Pankewycz, Oleh G. Nephrology Terrace View 462 GRIDER ST Buffalo NY 14215 Erie 7168983000

Pendyala, Prashant Nephrology Kidney and Hypertension Physician PC 2095 Kensington Ave Buffalo NY 14226 Erie 7166500373

Pendyala, Prashant Nephrology Kidney and Hypertension Physician PC 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166500373

Pendyala, Prashant Nephrology Niagara Hospitalist PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683514

Pendyala, Prashant Nephrology Terrace View 462 Grider st Buffalo NY 14215 Erie 7168983000

Pendyala, Prashant Nephrology Kidney and Hypertension Physician PC 290 Center Rd West Seneca NY 14224 Erie 7166500373

Quigg Jr, Richard J. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Quigg Jr, Richard J. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983152

Ranjan, Rajiv Nephrology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ryan III, James E. Nephrology Liberty RC Inc 550 Orchard Pk Rd West Seneca NY 14224 Erie 7166770089

Ryan III, James E. Nephrology Nephrology Associates of Western NY LLP 220 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7167120864

Ryan III, James E. Nephrology Min, Inkee 3801 Taylor Rd Orchard Park NY 14127 Erie 7162090105

Ryan III, James E. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Shafi, Mohamad Nephrology Shafi, Mohamad 3469 Harlem Rd Cheektowaga NY 14225 Erie 7168360016

Shafi, Mohamad Nephrology Buffalo Kidney Associates, LLP 3435 Bailey Ave Buffalo NY 14215 Erie 7168358615

Sridhar, Nagaraja R. Nephrology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7168578607

Sridhar, Nagaraja R. Nephrology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578607

Sridhar, Nagaraja R. Nephrology Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482124

Sridhar, Nagaraja R. Nephrology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168578607

Steinacher, Richard S. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Steinacher, Richard S. Nephrology Nephrology Associates of Western NY LLP 220 Redtail Rd Ste 2 Orchard Park NY 14127 Erie 7167120864

Su, Winnie S. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Su, Winnie S. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Tahir, Nauman Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Tahir, Nauman Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983152

Venuto, Rocco C. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984803

Venuto, Rocco C. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7169294650

Vijay, Dhanya B. Nephrology Western New York Truecare Medical PC 9630 Transit Rd Ste 1000 East Amherst NY 14051 Erie 7168176717

Wheat, Heather A. Nephrology Nephrology Associates of Western NY LLP 4233 Maple Rd Amherst NY 14226 Erie 7168383188

Zachariah, Mareena S. Nephrology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Zachariah, Mareena S. Nephrology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984803

Bennett, Gregory J. Neurological Surgery Erie Niagara Neurosurgery Pllc 18 Limestone Dr Ste 2 Buffalo NY 14221 Erie 7169327170

Bennett, Gregory J. Neurological Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Budny, James L. Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Buffalo NY 14226 Erie 7162181000

Castiglia, Gregory J. Neurological Surgery Buffalo Neurosurgery Pc 462 Grider St Buffalo NY 14215 Erie 7168399402

Castiglia, Gregory J. Neurological Surgery Buffalo Neurosurgery Pc 180 Park Club Ln Ste 100 Buffalo NY 14221 Erie 7168399402

DenHaese, Ryan P. Neurological Surgery Ryan P DenHaese 19 Limestone Dr Ste 11 Williamsville NY 14221 Erie 7166343500

DenHaese, Ryan P. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Egnatchik, James G. Neurological Surgery Buffalo Neurosurgery Pc 550 Orchard Pk Rd Ste A105 Buffalo NY 14224 Erie 7166775005

Fabiano, Andrew J. Neurological Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Fahrbach IV, John G. Neurological Surgery Terrace View 462 Grider St Buffalo NY 142153012 Erie 7168983325

Fahrbach IV, John G. Neurological Surgery Buffalo Neurosurgery Pc 180 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7168399402

Fenstermaker, Robert A. Neurological Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Gibbons, Kevin J. Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr 5th Fl Buffalo NY 14226 Erie 7162181000

Gibbons, Kevin J. Neurological Surgery University at Buffalo Neurosurgery Inc 200 Sterling Dr Orchard Park NY 14127 Erie 7162181000

Gibbons, Kevin J. Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Ste B4 Buffalo NY 14203 Erie 7162181000

Grand, Walter Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Ste B4 Buffalo NY 14203 Erie 7162181000

Grand, Walter Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Guterman, Lee R. Neurological Surgery Buffalo Neurosurgery Pc 4050 Harlem Rd Amherst NY 14226 Erie 7168031504

Guterman, Lee R. Neurological Surgery Clinical Neuroscience Services Med/Surg PLLC 4050 Harlem Rd Amherst NY 14226 Erie 7168031504

Guterman, Lee R. Neurological Surgery University at Buffalo Neurosurgery Inc 3 Gates Cir Buffalo NY 14209 Erie 7168593460

Guterman, Lee R. Neurological Surgery Buffalo Neurosurgery Pc 3980 Sheridan Dr 2nd Fl Buffalo NY 14226 Erie 7168031504

Hopkins, Leo N. Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Kansal, Narendra Neurological Surgery Kansal, Narendra 725 Orchard Park Rd West Seneca NY 14224 Erie 7166755010

Kansal, Narendra Neurological Surgery Kansal, Narendra 12845 Broadway Akron NY 14001 Erie 7166755010

Landi, Michael K. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Williamsville NY 14221 Erie 7168757399

Landi, Michael K. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Ste 2 Williamsville NY 14221 Erie 7166313555

Leonardo, Jody Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Leonardo, Jody Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Leonardo, Jody Neurological Surgery University at Buffalo Neurosurgery Inc 200 Sterling Dr Ste 300 Orchard Park NY 14127 Erie 7162181020

Levy, Elad I. Neurological Surgery University at Buffalo Neurosurgery Inc 3980 A SHERIDAN DR Buffalo NY 14226 Erie 7162181000

Levy, Elad I. Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Page 69 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Levy, Elad I. Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Lewis, Paul J. Neurological Surgery Buffalo Neurosurgery Pc 550 Orchard Pk Rd Ste A105 Buffalo NY 14224 Erie 7166776000

Li, Veetai Neurological Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787386

Li, Veetai Neurological Surgery Kaleida Health 936 Delaware Ave Buffalo NY 14209 Erie 7168781260

Li, Veetai Neurological Surgery University at Buffalo Neurosurgery Inc 219 Bryant St Buffalo NY 14222 Erie 7168787386

Moreland, Douglas B. Neurological Surgery Buffalo Neurosurgery Pc 180 Park Club Ln Ste 100 Buffalo NY 14221 Erie 7168399402

Plunkett Jr, Robert J. Neurological Surgery University at Buffalo Neurosurgery Inc 100 HIGH ST Buffalo NY 14203 Erie 7162181000

Plunkett Jr, Robert J. Neurological Surgery University at Buffalo Neurosurgery Inc 200 Sterling Dr Ste 300 Orchard Park NY 14127 Erie 7162181020

Plunkett Jr, Robert J. Neurological Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical 100 High St Buffalo NY 14203 Erie 7168597580

Plunkett Jr, Robert J. Neurological Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Plunkett Jr, Robert J. Neurological Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical 3 Gates Cir Buffalo NY 14209 Erie 7168875410

Plunkett Jr, Robert J. Neurological Surgery University at Buffalo Neurosurgery Inc Elm and Carlton Sts Buffalo NY 14263 Erie 7168453511

Pollina Jr, John Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Pollina Jr, John Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Reynolds, Renee M. Neurological Surgery University at Buffalo Neurosurgery Inc 219 Bryant St Buffalo NY 14222 Erie 7168787386

Reynolds, Renee M. Neurological Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781268

Roger, Eric P. Neurological Surgery 700 Michigan St Buffalo NY 14203 Erie 7168532225

Roger, Eric P. Neurological Surgery Eric P Roger MD PLLC 700 Michigan Ave Ste 210 Buffalo NY 14203 Erie 7168532225

Siddiqui, Adnan H. Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Siddiqui, Adnan H. Neurological Surgery University at Buffalo Neurosurgery Inc 3980 A Sheridan Dr Buffalo NY 14226 Erie 7162181000

Siddiqui, Adnan H. Neurological Surgery University at Buffalo Neurosurgery Inc Elm and Carlton Sts Buffalo NY 14263 Erie 7168453164

Snyder, Kenneth V. Neurological Surgery University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Snyder, Kenneth V. Neurological Surgery University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Amherst NY 14226 Erie 7162181000

Stoffman, Michael R. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Williamsville NY 14221 Erie 7168757399

Stoffman, Michael R. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Stoffman, Michael R. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Ste 300 Derby NY 14047 Erie 7166313555

Suddaby, Loubert S. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 3775 Southwestern Blvd Ste A Orchard Park NY 14127 Erie 7166313555

Yu, Young J. Neurological Surgery Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Ajtai, Bela Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Ajtai, Bela Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Arora, Gautam Neurology Hens Neurology PC 1829 Maple Rd Ste 102 Williamsville NY 14221 Erie 7162768375

Avino, Lorianne E. Neurology Lorianne E Pereira DO PC 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166083525

Avino, Lorianne E. Neurology Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Avino, Lorianne E. Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Avino, Lorianne E. Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Avino, Lorianne E. Neurology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Avino, Lorianne E. Neurology Avino, David 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

Avino, Lorianne E. Neurology Mercy Hospital 2157 Main St Buffalo NY 14214 Erie 7168622000

Avino, Lorianne E. Neurology Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Avino, Lorianne E. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Avino, Lorianne E. Neurology Mercy Hospital 2605 Harlem Rd (716)891-2400 NY 14225 Erie 7168912400

Avino, Lorianne E. Neurology Mercy Hospital 515 Abbott Rd Ste 310 Buffalo NY 14220 Erie 7168282300

Avino, Lorianne E. Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Avino, Lorianne E. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 2700 N Forest Rd Getzville NY 14068 Erie 7166393311

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 219 Bryant St Buffalo NY 14222 Erie 7166868460

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 100 Stahl Rd Getzville NY 14068 Erie 7168107330

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 100 High St Buffalo NY 14203 Erie 7166868460

Banas, Anne C. Neurology Hospice Buffalo Inc 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 225 Como Park Blvd Cheektowaga NY 14227 Erie 7166861900

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 2150 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166868460

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 150 Bennett Rd Buffalo NY 142271443 Erie 7166868460

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7166868460

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 1031 Michigan St Buffalo NY 14203 Erie 7166868460

Banas, Anne C. Neurology Palliative Care Physicians Group PLLC 462 Grider St Buffalo NY 14215 Erie 7166868460

Bates, Vernice E. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Bates, Vernice E. Neurology TCD Medical Testing PLLC 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502002

Battaglia, Michael J. Neurology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578624

Battaglia, Michael J. Neurology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7168578624

Blitshteyn, Svetlana Neurology Blitshteyn, Svetlana 100 College Pkwy Ste 150 Williamsville NY 14221 Erie 7165314598

Blitshteyn, Svetlana Neurology Buffalo Synapse Support 609 Ridge Rd Lackawanna NY 14218 Erie 7168039624

Block, Sandra A. Neurology Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301122

Block, Sandra A. Neurology Daniel I Rifkin Md Pc Dba Sleep Medicine C 1491 Sheridan Dr Kenmore NY 14223 Erie 7169237326

Block, Sandra A. Neurology Daniel I Rifkin Md Pc Dba Sleep Medicine C 3 Gates Cir Buffalo NY 14209 Erie 7168875337

Block, Sandra A. Neurology Daniel I Rifkin Md Pc Dba Sleep Medicine C 219 Bryant St Buffalo NY 14222 Erie 7169237326

Page 70 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Block, Sandra A. Neurology Daniel I Rifkin Md Pc Dba Sleep Medicine C 1120 Youngs Rd Williamsville NY 14221 Erie 7169237326

Block, Sandra A. Neurology Buffalo Synapse Support 609 Ridge Rd Lackawanna NY 14218 Erie 7168039624

Block, Sandra A. Neurology American Neuromonitoring Asso 325 Essjay Rd Williamsville NY 14221 Erie 7166301122

Block, Sandra A. Neurology Daniel I Rifkin Md Pc Dba Sleep Medicine C 4090 Seneca St Buffalo NY 14224 Erie 7169237326

Block, Sandra A. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Castellani, Daniel A. Neurology Castellani, Daniel 6245 Sheridan Dr Ste 216 Buffalo NY 14221 Erie 7166262647

Ching, Marilou I. Neurology Univ Neurology Inc 300 Essjay Rd Buffalo NY 14226 Erie 7169326080

Ching, Marilou I. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Ching, Marilou I. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Ching, Marilou I. Neurology Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168597566

Cohen, Michael E. Neurology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787840

Cohen, Michael E. Neurology Kaleida Health 4955 N Bailey Ave Buffalo NY 14221 Erie 7168597511

Cohen, Michael E. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787840

Cohen, Michael E. Neurology Univ Neurology Inc 300 Essjay Rd Ste 100 Williamsville NY 14221 Erie 7169326080

Deline, Christopher J. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Deline, Christopher J. Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Deline, Christopher J. Neurology Kaleida Health 100 High St D 3 Specialty Clinic Buffalo NY 14203 Erie 7168592524

Deline, Christopher J. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Deline, Christopher J. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Dominik, Jacob Neurology Sleep Insights Medical Services LLC 564 Niagara St Buffalo NY 14201 Erie 5853856070

Dominik, Jacob Neurology Sleep Insights Medical Services LLC 535 W Main St Springville NY 14141 Erie 5853856070

Dominik, Jacob Neurology Sleep Insights Medical Services LLC 760 Dick Rd Buffalo NY 14225 Erie 5853856070

Elrich, Susan M. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Ferguson, Richard E. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Fiddler, Alyssa B. Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Fiddler, Alyssa B. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168593720

Fine, Edward J. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168597511

Finnegan, Sarah G. Neurology Kaleida Health 4955 N Bailey Ave Buffalo NY 14221 Erie 7168597511

Finnegan, Sarah G. Neurology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787840

Frost, Marc Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Frost, Marc Neurology Dent Neurologic Group LLP 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7162502000

Giglio, Michael A. Neurology Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Giglio, Michael A. Neurology Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Ste 300 Derby NY 14047 Erie 7166313555

Gu, Eugene Y. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Gu, Eugene Y. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Guerch, Meziane A. Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Guttuso Jr, Thomas J. Neurology Univ Neurology Inc 300 Essjay Rd Ste 100 Williamsville NY 14221 Erie 7169326080

Guttuso Jr, Thomas J. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Guttuso Jr, Thomas J. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Hoffman, David E. Neurology Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301006

Hojnacki, David W. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Hojnacki, David W. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Hojnacki, David W. Neurology Univ Neurology Inc ELM AND CARLTON ST Buffalo NY 14263 Erie 7168452300

Hojnacki, David W. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Holmlund, Tomas H. Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Holmlund, Tomas H. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Hourihane, J Maurice Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Hughes, Patrick J. Neurology Patrick J. Hughes, MD 240 Redtail Dr Ste 10 Orchard Park NY 14127 Erie 7166776700

Ionita, Catalina C. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168875410

Ionita, Catalina C. Neurology Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168597566

Ionita, Catalina C. Neurology Mercy Hospital 2157 Main St Buffalo NY 14214 Erie 7168622000

Ionita, Catalina C. Neurology Mercy Hospital 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Ionita, Catalina C. Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Ionita, Catalina C. Neurology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Ionita, Catalina C. Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ionita, Catalina C. Neurology Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Ionita, Catalina C. Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ionita, Catalina C. Neurology University at Buffalo Neurosurgery Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874960

Ionita, Catalina C. Neurology Mercy Hospital 515 Abbott Rd Ste 310 Buffalo NY 14220 Erie 7168282300

Jani, Ronak B. Neurology Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Kalonaros, George C. Neurology George C Kalonaros MD 2950 Elmwood Ave Kenmore NY 14217 Erie 7164477260

Kalonaros, George C. Neurology Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Kalonaros, George C. Neurology George C Kalonaros MD 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7164477260

Kalonaros, George C. Neurology Kenmore Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Kandel, Amit Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Kandel, Amit Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Page 71 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kandel, Amit Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Kang, Minsoo Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Kang, Minsoo Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Kass-Hout, Omar Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168283123

Kass-Hout, Omar Neurology Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Kerr, Susan L. Neurology Univ Neurology Inc 300 Essjay Rd Ste 100 Buffalo NY 14226 Erie 7169326080

Kerr, Susan L. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787840

Kinkel, Peter R. Neurology Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Kinkel, Peter R. Neurology Kinkel Neurologic Center LLP 5 Limestone Dr Ste B Williamsville NY 14221 Erie 7166329399

Kinkel, Peter R. Neurology Seton Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476856

Kinkel, William R. Neurology Kinkel Neurologic Center LLP 5 Limestone Dr Ste B Williamsville NY 14221 Erie 7166329399

Kinkel, William R. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Kinkel, William R. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Kinkel, William R. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168597511

Kolb, Channa M. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Kolb, Channa M. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Kolb, Channa M. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Lee Kwen, Peterkin Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lee Kwen, Peterkin Neurology Southtowns Neurology of WNY 3775 Seneca St West Seneca NY 14224 Erie 7167120890

Li, Ping Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168597511

Li, Ping Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Li, Ping Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Li, XiuLi Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Li, XiuLi Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Amherst NY 14226 Erie 7162502000

Lichter, David G. Neurology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Lichter, David G. Neurology Kaleida Health 100 High St Neurology Dept Buffalo NY 14203 Erie 7168592175

Lichter, David G. Neurology Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Williamsville NY 14221 Erie 7168757399

Lichter, David G. Neurology Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Ste 300 Derby NY 14047 Erie 7166313555

Lichter, David G. Neurology Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Luthra, Ranjana Neurology St Joseph Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7168912423

Luthra, Ranjana Neurology Ranjana Luthra MD 2075 Kensington Ave Snyder NY 14226 Erie 7168393717

Luthra, Ranjana Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

McVige, Jennifer W. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr 3rd Fl Amherst NY 14226 Erie 7162502000

Mechtler, Laszlo L. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Buffalo NY 14267 Erie 7162502000

Mechtler, Laszlo L. Neurology Advanced Imaging Associates PC 2625 Harlem Rd Ste 110 Buffalo NY 14225 Erie 7168972207

Mechtler, Laszlo L. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14205 Erie 7168874600

Mechtler, Laszlo L. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Mechtler, Laszlo L. Neurology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168453154

Mechtler, Laszlo L. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Mechtler, Laszlo L. Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Meyer, Michael A. Neurology Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Meyer, Michael A. Neurology Mercy Hospital 2157 Main St Buffalo NY 14214 Erie 7168622000

Mowla, Ashkan Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Mowla, Ashkan Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Mowla, Ashkan Neurology Kaleida Health 100 High St D 3 Specialty Clinic Buffalo NY 14203 Erie 7168592524

Mowla, Ashkan Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Murray, Kenneth R. Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Murray, Kenneth R. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Myers, Bennett H. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Myers, Bennett H. Neurology Dent Neurologic Group LLP 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7162502000

Paroski, Margaret W. Neurology Univ Neurology Inc 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Paroski, Margaret W. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Paroski, Margaret W. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14205 Erie 7168875410

Paroski, Margaret W. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Paroski, Margaret W. Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Paroski, Margaret W. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Paroski, Margaret W. Neurology Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Paroski, Margaret W. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168593720

Paroski, Margaret W. Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Paroski, Margaret W. Neurology Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168320643

Patel, Malti J. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Pfiffner, Thomas J. Neurology Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Radovic, Vladan M. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Radovic, Vladan M. Neurology Kaleida Health 100 High St E2 Jacobs Neur Dept Buffalo NY 14203 Erie 7168597511

Roehmholdt, Mary E. Neurology Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Roehmholdt, Mary E. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Page 72 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Roehmholdt, Mary E. Neurology Mary Elizabeth Roehmholdt 300 Essjay Rd Ste 105 Williamsville NY 14221 Erie 7166346357

Roehmholdt, Mary E. Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Roehmholdt, Mary E. Neurology Kenmore Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Rojas, Luisa Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Buffalo NY 14226 Erie 7162502000

Rojas, Luisa Neurology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Saikali, Nicolas P. Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Amherst NY 14226 Erie 7162502000

Samie, Mohammad R. Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Samie, Mohammad R. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Samie, Mohammad R. Neurology Samie, M Reza 1616 Kensington St Buffalo NY 14215 Erie 7168283400

Samie, Mohammad R. Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Samie, Mohammad R. Neurology Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Samie, Mohammad R. Neurology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Samie, Mohammad R. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168875410

Samie, Mohammad R. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Samie, Mohammad R. Neurology Univ Neurology Inc 445 Tremont St Tonawanda NY 14150 Erie 7166944500

Samie, Mohammad R. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168597511

Samie, Mohammad R. Neurology Samie, M Reza 515 Abbott Rd Ste 400 Buffalo NY 14220 Erie 7168283400

Samie, Mohammad R. Neurology Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168320643

Samie, Mohammad R. Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Sawyer, Robert N. Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Sawyer, Robert N. Neurology Univ Neurology Inc Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Sawyer, Robert N. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Sawyer, Robert N. Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Sawyer, Robert N. Neurology Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168597566

Sawyer, Robert N. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Sawyer, Robert N. Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Sawyer, Robert N. Neurology Kaleida Health 100 High St D3 Buffalo NY 14203 Erie 7168592524

Sawyer, Robert N. Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Shastri, Kalyan K. Neurology Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Shin, In Sook J. Neurology Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Shirani, Peyman Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Shirani, Peyman Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Shirani, Peyman Neurology Kaleida Health 100 High St D 3 Specialty Clinic Buffalo NY 14203 Erie 7168592524

Shirani, Peyman Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Silvestri, Nicholas J. Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Silvestri, Nicholas J. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Silvestri, Nicholas J. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Silvestri, Nicholas J. Neurology Univ Neurology Inc 300 Essjay Rd Buffalo NY 14226 Erie 7169326080

Silvestri, Nicholas J. Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Silvestri, Nicholas J. Neurology Kaleida Health 100 High St E2 Jacobs Neur Dept Buffalo NY 14203 Erie 7168597511

Silvestri, Nicholas J. Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Silvestri, Nicholas J. Neurology Univ Neurology Inc 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Singh, Baljinder Neurology Baljinder Singh MD 310 Sterling Dr Ste 110 Orchard Park NY 14127 Erie 7166916283

Singh, Baljinder Neurology Baljinder Singh MD 6105 Transit Rd Ste 160 East Amherst NY 14051 Erie 7166916283

Singh, Baljinder Neurology Eastern Niagara Neurology PC 8207 Main St Ste 7 Williamsville NY 14221 Erie 7165750075

Szigeti, Kinga G. Neurology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Szigeti, Kinga G. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Szigeti, Kinga G. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Trinidad, Kimberly S. Neurology University at Buffalo Neurosurgery Inc 100 High St Buffalo NY 14203 Erie 7162181000

Trinidad, Kimberly S. Neurology University at Buffalo Neurosurgery Inc 200 Sterling Dr Ste 300 Orchard Park NY 14127 Erie 7162181020

Wang, Eugene Neurology Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Weinstock Guttman, Bianca Neurology Univ Neurology Inc Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168320643

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Weinstock Guttman, Bianca Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Weinstock Guttman, Bianca Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168875410

Withiam Leitch, Sherry A. Neurology Withiam-Leitch, Sherry 100 Stahl Rd Getzville NY 14068 Erie 7165041000

Withiam Leitch, Sherry A. Neurology Withiam-Leitch, Sherry 462 Grider St Buffalo NY 14215 Erie 7168983638

Withiam Leitch, Sherry A. Neurology Withiam-Leitch, Sherry 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Withiam Leitch, Sherry A. Neurology Withiam-Leitch, Sherry 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Wolfe, Gil I. Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Wolfe, Gil I. Neurology Kaleida Health 100 High St D-3 Buffalo NY 14203 Erie 7168592524

Page 73 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Wolfe, Gil I. Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Wolfe, Gil I. Neurology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Zhang, Lixin Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Duffner, Patricia K. Neurology w/ Child Neuro Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168320643

Duffner, Patricia K. Neurology w/ Child Neuro Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Duffner, Patricia K. Neurology w/ Child Neuro Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Duffner, Patricia K. Neurology w/ Child Neuro Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787840

Farooq, Osman Neurology w/ Child Neuro Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Farooq, Osman Neurology w/ Child Neuro Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Farooq, Osman Neurology w/ Child Neuro Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787840

Farooq, Osman Neurology w/ Child Neuro Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787840

Hartley McAndrew, Michelle E. Neurology w/ Child Neuro Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787840

Hartley McAndrew, Michelle E. Neurology w/ Child Neuro Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Hartley McAndrew, Michelle E. Neurology w/ Child Neuro Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7166944500

Hartley McAndrew, Michelle E. Neurology w/ Child Neuro Univ Neurology Inc 300 Essjay Rd Buffalo NY 14221 Erie 7169326080

Kakish, Khalid S. Neurology w/ Child Neuro Kaleida Health 219 Bryant St 1st Fl Buffalo NY 14222 Erie 7168787840

Kakish, Khalid S. Neurology w/ Child Neuro Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Kakish, Khalid S. Neurology w/ Child Neuro Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Kerr, Susan L. Neurology w/ Child Neuro Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Kerr, Susan L. Neurology w/ Child Neuro Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787848

Kerr, Susan L. Neurology w/ Child Neuro Kaleida Health 4955 N Bailey Ave Buffalo NY 14221 Erie 7168597511

Langan, Thomas J. Neurology w/ Child Neuro Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 445 Tremont St Tonawanda NY 14150 Erie 7166944500

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Langan, Thomas J. Neurology w/ Child Neuro Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Qasaymeh, Mohammad M. Neurology w/ Child Neuro Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Qasaymeh, Mohammad M. Neurology w/ Child Neuro Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Rovner, Alexander V. Neurology w/ Child Neuro Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Rovner, Alexander V. Neurology w/ Child Neuro Kenmore Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Rovner, Alexander V. Neurology w/ Child Neuro Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Rovner, Alexander V. Neurology w/ Child Neuro Buffalo Synapse Support 609 Ridge Rd Lackawanna NY 14218 Erie 7168039624

Rovner, Alexander V. Neurology w/ Child Neuro Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164416100

Rovner, Alexander V. Neurology w/ Child Neuro Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rovner, Alexander V. Neurology w/ Child Neuro Rovner, Alexander 4772 N French Rd East Amherst NY 14051 Erie 7164042604

Rovner, Alexander V. Neurology w/ Child Neuro Rovner, Alexander 3775 Seneca St Buffalo NY 14224 Erie 7169133917

Weinstock, Arie L. Neurology w/ Child Neuro Kaleida Health 219 Bryant St 1st Fl Buffalo NY 14222 Erie 7168787840

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Weinstock, Arie L. Neurology w/ Child Neuro Kaleida Health 4955 N Bailey Ave Buffalo NY 14221 Erie 7168597511

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 3 Gates Cir Buffalo NY 14205 Erie 7168875410

Weinstock, Arie L. Neurology w/ Child Neuro Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168597511

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168597511

Weinstock, Arie L. Neurology w/ Child Neuro Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787840

Weinstock, Arie L. Neurology w/ Child Neuro Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Weinstock, Arie L. Neurology w/ Child Neuro Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 300 Essjay Rd Buffalo NY 14226 Erie 7169326080

Weinstock, Arie L. Neurology w/ Child Neuro Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Corigliano, Joseph F. Neuromusculoskeletal Med Buffalo Medical Group 325 Essjay Rd Ste 110 Williamsville NY 14221 Erie 7166301465

Rong, Rong Neuropathology University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Rong, Rong Neuropathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168565600

Baker, John G. Neuropsychology University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Baker, John G. Neuropsychology University Orthopaedics Services Inc 100 High St Buffalo NY 14203 Erie 7168591256

Baker, John G. Neuropsychology University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Baker, John G. Neuropsychology University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Baker, John G. Neuropsychology University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

Benedict, Ralph H. Neuropsychology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Benedict, Ralph H. Neuropsychology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Benedict, Ralph H. Neuropsychology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168597511

Czarnecki, Donna M. Neuropsychology Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Duquin, J A. Neuropsychology Dent Neurologic Group LLP 3980 Sheridan Dr Amherst NY 14226 Erie 7162502000

Gunther, Mark W. Neuropsychology Dent Neurologic Group LLP 3980 Sheridan Dr Amherst NY 14226 Erie 7162502000

Page 74 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Gunther, Mark W. Neuropsychology Gunther, Mark 462 Grider St Rm 943 Buffalo NY 14215 Erie 7168983955

Parrish, Joy B. Neuropsychology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Parrish, Joy B. Neuropsychology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Parrish, Joy B. Neuropsychology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Parrish, Joy B. Neuropsychology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Alberico, Ronald A. Neuroradiology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Alberico, Ronald A. Neuroradiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787538

Gopal, Hari Neuroradiology Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Kartha, Krishnan Neuroradiology Advanced Imaging Associates PC 2625 Harlem Rd Ste 110 Cheektowaga NY 14225 Erie 7168972207

Mikityansky, Igor Neuroradiology Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Mikityansky, Igor Neuroradiology Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Mikityansky, Igor Neuroradiology Windsong Radiology Pc 1026 Union Rd Ste 1 Buffalo NY 14224 Erie 7166755600

Mikityansky, Igor Neuroradiology Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Mikityansky, Igor Neuroradiology Windsong Radiology Pc 3950 E Robinson Rd Buffalo NY 14228 Erie 7166911200

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476020

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 94 Olean St East Aurora NY 14052 Erie 7166552525

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 550 Orchard Park Rd West Seneca NY 14224 Erie 7165585140

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Qureshi, Zeeshan M. Neuroradiology Southtowns Radiological As 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Qureshi, Zeeshan M. Neuroradiology SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Zimmer, Wendy E. Neuroradiology Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Buffalo Cardiology and Pulmonary Associates 3980 Sheridan Dr Amherst NY 14226 Erie 7162502000

Abdel Nabi, Hani H. Nuclear Medicine Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502045

Abdel Nabi, Hani H. Nuclear Medicine Hani Abdel-Nabi, MD, PC 1616 Kensington Ave Buffalo NY 14215 Erie 7168365500

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Bruce L Platt MD PC 1616 Kensington Ave Buffalo NY 14215 Erie 7168343278

Abdel Nabi, Hani H. Nuclear Medicine Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Abdel Nabi, Hani H. Nuclear Medicine Buffalo Cardiology and Pulmonary Associates 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Abdel Nabi, Hani H. Nuclear Medicine Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Baeumler, George R. Nuclear Medicine University Neuclear Med Dept 97 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476541

Baeumler, George R. Nuclear Medicine University Neuclear Med Dept 97 100 High St Buffalo NY 14203 Erie 7168591144

Baeumler, George R. Nuclear Medicine SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Baeumler, George R. Nuclear Medicine SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Baeumler, George R. Nuclear Medicine SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476020

Baeumler, George R. Nuclear Medicine SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Baeumler, George R. Nuclear Medicine SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Baeumler, George R. Nuclear Medicine Kenmore Nuclear Medicine, PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476179

Baeumler, George R. Nuclear Medicine SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Bedmutha, Shantikumar D. Nuclear Medicine Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

Bedmutha, Shantikumar D. Nuclear Medicine Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

Page 75 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Bedmutha, Shantikumar D. Nuclear Medicine Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Bedmutha, Shantikumar D. Nuclear Medicine Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14211 Erie 8008410417

Bedmutha, Shantikumar D. Nuclear Medicine Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

Bedmutha, Shantikumar D. Nuclear Medicine Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Bedmutha, Shantikumar D. Nuclear Medicine WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Bedmutha, Shantikumar D. Nuclear Medicine Bedmutha, Shantikumar 462 Grider St Buffalo NY 14215 Erie 7168983419

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Bedmutha, Shantikumar D. Nuclear Medicine Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

Bedmutha, Shantikumar D. Nuclear Medicine Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14203 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 7168552866

DeSouza, Noyel V. Nuclear Medicine Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

DeSouza, Noyel V. Nuclear Medicine Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 7168552866

Drakopoulos, Marinos Nuclear Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Gannon, James M. Nuclear Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Gona, Jayakumari M. Nuclear Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hakim, Shabbir Z. Nuclear Medicine Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621527

Hakim, Shabbir Z. Nuclear Medicine Nuclear Medicine Associates Llp 565 Abbott Rd Buffalo NY 14220 Erie 7168282169

Hakim, Shabbir Z. Nuclear Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Hakim, Shabbir Z. Nuclear Medicine University Neuclear Med Dept 97 219 Bryant St Buffalo NY 14222 Erie 7168787063

Hakim, Shabbir Z. Nuclear Medicine Southtowns Radiological As 3050 Orchard Pk Rd Buffalo NY 14224 Erie 7165585400

Hakim, Shabbir Z. Nuclear Medicine Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Hakim, Shabbir Z. Nuclear Medicine Nuclear Medicine Associates Llp 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476176

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Hakim, Shabbir Z. Nuclear Medicine Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Hakim, Shabbir Z. Nuclear Medicine Dent Neurologic Group LLP 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Hakim, Shabbir Z. Nuclear Medicine Dent Neurologic Group LLP 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Hakim, Shabbir Z. Nuclear Medicine Dent Neurologic Group LLP 3050 Orchard park Rd Buffalo NY 14224 Erie 7165585400

Hakim, Shabbir Z. Nuclear Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hakim, Shabbir Z. Nuclear Medicine Southtowns Radiological As 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Hakim, Shabbir Z. Nuclear Medicine Sisters Diagnostic Imaging 2605 Harlem Rd Buffalo NY 14225 Erie 7166338675

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Hakim, Shabbir Z. Nuclear Medicine SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Hakim, Shabbir Z. Nuclear Medicine Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Husain, Syed S. Nuclear Medicine Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Husain, Syed S. Nuclear Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Husain, Syed S. Nuclear Medicine VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Husain, Syed S. Nuclear Medicine Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14225 Erie 7168223098

Jabi, Feraas Nuclear Medicine University Neuclear Med Dept 97 100 High St Buffalo NY 14203 Erie 7168591144

Jabi, Feraas Nuclear Medicine University Neuclear Med Dept 97 1630 Maple Rd Williamsville NY 14221 Erie 7165803608

Joo, Kwang G. Nuclear Medicine SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476020

Joo, Kwang G. Nuclear Medicine SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Joo, Kwang G. Nuclear Medicine Kenmore Nuclear Medicine, PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476179

Joo, Kwang G. Nuclear Medicine University Neuclear Med Dept 97 100 High St Buffalo NY 14203 Erie 7168591144

Joo, Kwang G. Nuclear Medicine SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Joo, Kwang G. Nuclear Medicine SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Joo, Kwang G. Nuclear Medicine SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Joo, Kwang G. Nuclear Medicine SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Page 76 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Klitzke, Alan K. Nuclear Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Lamonica, Dominick M. Nuclear Medicine Dent Neurologic Group LLP 5500 Main St Ste 347 Williamsville NY 14221 Erie 7162502000

Lamonica, Dominick M. Nuclear Medicine Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Lamonica, Dominick M. Nuclear Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Liu, HongBiao Nuclear Medicine Luna Medical Care PC 656 Elmwood Ave Buffalo NY 14222 Erie 7162047458

Ludwig, David R. Nuclear Medicine Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Ludwig, David R. Nuclear Medicine Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Ludwig, David R. Nuclear Medicine Parkland Diagnostic Imaging 3055 Southwestern Blvd Ste 104 Orchard Park NY 14127 Erie 7166776736

Ludwig, David R. Nuclear Medicine Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Ludwig, David R. Nuclear Medicine Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Mascaro, Frank J. Nuclear Medicine Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14203 Erie 7168552860

Mascaro, Frank J. Nuclear Medicine WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Meyer, Michael A. Nuclear Medicine Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Meyer, Michael A. Nuclear Medicine Mercy Hospital 2157 Main St Buffalo NY 14214 Erie 7168622000

Miletich, Robert S. Nuclear Medicine University Neuclear Med Dept 97 3435 Main St 105 Parker Hall Buffalo NY 14214 Erie 7168348194

Miletich, Robert S. Nuclear Medicine University Neuclear Med Dept 97 1630 Maple Rd Williamsville NY 14221 Erie 7168782998

Miletich, Robert S. Nuclear Medicine Dent Neurologic Group LLP 3980 Sheridan Dr Amherst NY 14226 Erie 7162502000

Miletich, Robert S. Nuclear Medicine Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Miletich, Robert S. Nuclear Medicine University Neuclear Med Dept 97 1616 Kensington Ave Buffalo NY 14215 Erie 7168313005

Miletich, Robert S. Nuclear Medicine Dent Neurologic Group LLP 3980 Sheridan Dr Dent Tower Amherst NY 14226 Erie 7162502045

Miletich, Robert S. Nuclear Medicine University Neuclear Med Dept 97 219 Bryant St Buffalo NY 14222 Erie 7168787063

Naples, Nicholas Nuclear Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Naples, Nicholas Nuclear Medicine Buffalo Medical Group 425 Essjay Rd Amherst NY 14221 Erie 7166301000

Naples, Nicholas Nuclear Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Naples, Nicholas Nuclear Medicine Buffalo Medical Group 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7166301164

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Parthasarathy, Kondai L. Nuclear Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Parthasarathy, Kondai L. Nuclear Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Parthasarathy, Kondai L. Nuclear Medicine Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Parthasarathy, Kondai L. Nuclear Medicine SRA Medical Imaging LLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Rehman, Fazalur C. Nuclear Medicine Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Rehman, Fazalur C. Nuclear Medicine Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621527

Rehman, Fazalur C. Nuclear Medicine University Neuclear Med Dept 97 Macc 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7168282169

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Rehman, Fazalur C. Nuclear Medicine Nuclear Medicine Associates Llp 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476176

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rehman, Fazalur C. Nuclear Medicine Sisters Diagnostic Imaging 2605 Harlem Rd Buffalo NY 14225 Erie 7166338675

Rehman, Fazalur C. Nuclear Medicine Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Rehman, Fazalur C. Nuclear Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Rehman, Fazalur C. Nuclear Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Rehman, Fazalur C. Nuclear Medicine SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Rehman, Fazalur C. Nuclear Medicine Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Rehman, Fazalur C. Nuclear Medicine Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Rehman, Fazalur C. Nuclear Medicine Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Rehman, Fazalur C. Nuclear Medicine Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Turaif, Najat A. Nuclear Medicine Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Turaif, Najat A. Nuclear Medicine Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Buffalo Heart Group LCP 3091 William St Cheektowaga NY 14215 Erie 7168223098

Turaif, Najat A. Nuclear Medicine Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352981

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Page 77 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Turaif, Najat A. Nuclear Medicine University Neuclear Med Dept 97 219 Bryant St Buffalo NY 14222 Erie 7168787063

Turaif, Najat A. Nuclear Medicine WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Turaif, Najat A. Nuclear Medicine Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Turaif, Najat A. Nuclear Medicine Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Turaif, Najat A. Nuclear Medicine Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Ablove, Tova S. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 100 High St C-3 Outpatient Surgical Suite Buffalo NY 14203 Erie 7166368284

Ablove, Tova S. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787263

Ablove, Tova S. Obstetrics and Gynecology Kaleida Health 100 High St D Basement Buffalo NY 14203 Erie 7168592175

Ablove, Tova S. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Ablove, Tova S. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Ablove, Tova S. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ablove, Tova S. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Abu Sitta, Moeen I. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Abu Sitta, Moeen I. Obstetrics and Gynecology Moeen Abu-Sitta MD PC 755 Wehrle Dr Buffalo NY 14225 Erie 7166340600

Abu Sitta, Moeen I. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Adams, Lan L. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Adams, Lan L. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Adams, Lan L. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 204 Buffalo NY 14220 Erie 7168283650

Allen, Elizabeth A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Allen, Elizabeth A. Obstetrics and Gynecology Suburban Women's Healthcare 3620 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7168765512

Arnold, Jo Anne Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Arnold, Jo Anne Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787877

Arnold, Jo Anne Obstetrics and Gynecology Audubon Womens Medical Assoc Pc 1360 N Forest Rd Ste 102 Williamsville NY 14221 Erie 7166394034

Arnold, Jo Anne Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787877

Arnold, Jo Anne Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165686776

Arnold, Jo Anne Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Arnold, Jo Anne Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7166944500

Arnold, Ryan C. Obstetrics and Gynecology General Physician PC 240 Red Tail Dr Ste 6 Orchard Park NY 14127 Erie 7166770454

Aronica, Lynn Marie Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Aronica, Lynn Marie Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Arroyo, Armando Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Arroyo, Armando Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787263

Arroyo, Armando Obstetrics and Gynecology Kaleida Health 11 Summer St 2nd Fl Buffalo NY 14209 Erie 7168810400

Arroyo, Armando Obstetrics and Gynecology Cny Fertility Center 835 Hopkins Rd Williamsville NY 14221 Erie 3154698700

Arroyo, Armando Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1540 Maple Rd Ste 25 Williamsville NY 14221 Erie 7164331941

Arroyo, Armando Obstetrics and Gynecology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Arroyo, Armando Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1315 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Arroyo, Armando Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1150 Youngs Rd Ste 208 Buffalo NY 14221 Erie 7166369112

Arroyo, Armando Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Arroyo, Armando Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787861

Ashraf, Saima Obstetrics and Gynecology Lake Erie Medical Services, PC 826 Lake St Angola NY 14006 Erie 7166722000

Ayromlooi, Jahangir Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 268 Main St East Aurora NY 14052 Erie 7166528606

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Baczkowski, Sheri L. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 2072 Kensington Ave Buffalo NY 14226 Erie 7168834350

Baczkowski, Sheri L. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Bagnarello, Carola E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 2780 Delaware Ave Kenmore NY 14217 Erie 7166336363

Bagnarello, Carola E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Bagnarello, Carola E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 30 N Union Rd Ste 101 Williamsville NY 14221 Erie 7166336363

Bagnarello, Carola E. Obstetrics and Gynecology Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Balaya, Farkad Obstetrics and Gynecology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168985240

Balaya, Farkad Obstetrics and Gynecology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 1275 Delaware Ave Buffalo NY 14209 Erie 7168822424

Balaya, Farkad Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Balaya, Farkad Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Balaya, Farkad Obstetrics and Gynecology General Physician PC 1275 Delaware Ave Buffalo NY 14209 Erie 7168822424

Page 78 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 100 High St Buffalo NY 14203 Erie 7168595600

Balaya, Farkad Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Balaya, Farkad Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 1150 Youngs Rd Ste 208 Williamsville NY 14221 Erie 7166369112

Balaya, Farkad Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Balaya, Farkad Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Balaya, Farkad Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Balaya, Farkad Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Balaya, Farkad Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Balaya, Farkad Obstetrics and Gynecology Farkad Balaya MD, PLLC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ball, Jodi S. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 3834 Delaware Ave Kenmore NY 14217 Erie 7168771221

Ball, Jodi S. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 6440 Transit Rd Depew NY 14043 Erie 7166845454

Barnabei, Vanessa M. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1150 Youngs Rd Williamsville NY 14221 Erie 7162428511

Barnabei, Vanessa M. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Barnabei, Vanessa M. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Barnabei, Vanessa M. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Barnabei, Vanessa M. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Barnabei, Vanessa M. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Barnabei, Vanessa M. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Barnabei, Vanessa M. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Barr, Jennifer J. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Barr, Jennifer J. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Bartels, Edward K. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 6440 Transit Rd Depew NY 14043 Erie 7166845454

Bartels, Edward K. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 3834 Delaware Ave Kenmore NY 14217 Erie 7168771221

Beckwith, Michael G. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Beckwith, Michael G. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787737

Beckwith, Michael G. Obstetrics and Gynecology Kaleida Health 6363 Transit Rd Ste 500 Depew NY 14043 Erie 7168787737

Beckwith, Michael G. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Betstadt, Sarah J. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Betstadt, Sarah J. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 268 Main St East Aurora NY 14052 Erie 7166528606

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Bond, Virginia K. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 2072 Kensington Ave Buffalo NY 14226 Erie 7168834350

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Bond, Virginia K. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Bond, Virginia K. Obstetrics and Gynecology General Physician PC 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7167120862

Brar, Mandeep K. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787861

Brar, Mandeep K. Obstetrics and Gynecology CHC of Buffalo INC 34 Benwood Ave Buffalo NY 14214 Erie 7169869199

Brar, Mandeep K. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 100 High St Buffalo NY 14203 Erie 7168592524

Brar, Mandeep K. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1540 Maple Rd Ste 25 Williamsville NY 14221 Erie 7165686572

Brar, Mandeep K. Obstetrics and Gynecology Terrace View 219 Bryant St Buffalo NY 14222 Erie 7168787000

Brebnor, Angelle A. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Brebnor, Angelle A. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Brebnor, Angelle A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7166923302

Brebnor, Angelle A. Obstetrics and Gynecology Kaleida Health 239 Bryant St Ste 295D Buffalo NY 14222 Erie 7168787737

Brebnor, Angelle A. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Bruno Jr, August A. Obstetrics and Gynecology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564811

Bruno Jr, August A. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Buffalo NY 14220 Erie 7168283520

Bruno Jr, August A. Obstetrics and Gynecology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578632

Bruno Jr, August A. Obstetrics and Gynecology Buffalo Medical Group 410 Abbott Rd Buffalo NY 14220 Erie 7166564811

Burns, Daniel A. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Burns, Daniel A. Obstetrics and Gynecology Burns MD & Hage MD PC 7020 Erie Rd Derby NY 14047 Erie 7169474545

Burns, Daniel A. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Calabrese, Michael D. Obstetrics and Gynecology Michael D Calabrese MD PC 656 Elmwood Ave Buffalo NY 14222 Erie 7168830515

Chouchani, Adel E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 12845 Broadway Alden NY 14004 Erie 7162599026

Chouchani, Adel E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 2780 Delaware Ave Kenmore NY 14217 Erie 7166336363

Chouchani, Adel E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7162598220

Chouchani, Adel E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Chouchani, Adel E. Obstetrics and Gynecology Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Chouchani, Adel E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 30 N Union Rd Ste 101 Williamsville NY 14221 Erie 7166336363

Chouchani, Christian P. Obstetrics and Gynecology Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Page 79 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Chouchani, Christian P. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621969

Chouchani, Christian P. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 30 N Union Rd Ste 101 Williamsville NY 14221 Erie 7166336363

Chouchani, Christian P. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 12845 Broadway Alden NY 14004 Erie 7166336363

Chouchani, Christian P. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Chouchani, Christian P. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Chouchani, Christian P. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 2780 Delaware Ave Ste 204 Kenmore NY 14217 Erie 7162518220

Chouchani, Christian P. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Chouchani, Christian P. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Chouchani, Christian P. Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Chouchani, Gabriel E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Chouchani, Gabriel E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 30 N Union Rd Ste 101 Williamsville NY 14221 Erie 7166336363

Chouchani, Gabriel E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166334575

Chouchani, Gabriel E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 2780 Delaware Ave Kenmore NY 14217 Erie 7166336363

Chouchani, Gabriel E. Obstetrics and Gynecology Kenmore Mercy Hospital 30 N Union Rd Ste 101 Williamsville NY 14221 Erie 7166336363

Chouchani, Gabriel E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166334575

Cloud, Marsilia S. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 6440 Transit Rd Depew NY 14043 Erie 7166845454

Cloud, Marsilia S. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 3834 Delaware Ave Kenmore NY 14217 Erie 7168771221

Constantine, Jeffrey C. Obstetrics and Gynecology Constantine, Jeffrey 1595 Bailey Ave Buffalo NY 14212 Erie 7168938550

Constantine, Jeffrey C. Obstetrics and Gynecology Constantine, Jeffrey 85 Wehrle Dr Ste 1 Cheektowaga NY 14225 Erie 7168360059

Constantine, Jeffrey C. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Constantine, Jeffrey C. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Constantine, Jeffrey C. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283528

Constantine, Jeffrey C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Constantine, Jeffrey C. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd West Seneca NY 14220 Erie 7168267000

Constantine, Jeffrey C. Obstetrics and Gynecology Buffalo Medical Group Dept 316 PO Box 8000 Buffalo NY 14267 Erie 7166302513

Constantine, Jeffrey C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Corigliano, Maria A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Corigliano, Maria A. Obstetrics and Gynecology Audubon Womens Medical Assoc Pc 1360 N Forest Rd Ste 102 Buffalo NY 14221 Erie 7166394034

Costich, Theodore G. Obstetrics and Gynecology Maple Medical Sevices PC 41 Maple Rd Williamsville NY 14221 Erie 7166311045

Costich, Theodore G. Obstetrics and Gynecology Elmwood Health Center 1219 N Forest PO Box 9033 Williamsville NY 14221 Erie 7168744500

Cromwell, Nicholas L. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Cromwell, Nicholas L. Obstetrics and Gynecology Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Cromwell, Nicholas L. Obstetrics and Gynecology Cromwell, Nicholas 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Cromwell, Nicholas L. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd West Seneca NY 14220 Erie 7168267000

Cromwell, Nicholas L. Obstetrics and Gynecology Mercy Hospital 27 Franklin St Ste 1 Springville NY 14141 Erie 7165927400

D Souza, Caroline A. Obstetrics and Gynecology Amherst Ob/Gyn Associates PC 8750 Transit Rd Ste 205 East Amherst NY 14051 Erie 7166397970

Danakas, George T. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165686776

Danakas, George T. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Danakas, George T. Obstetrics and Gynecology George Danakas 2072 Kensington Ave Buffalo NY 14226 Erie 7168834350

Danakas, George T. Obstetrics and Gynecology Kaleida Health 726 Exchange St Ste 300 Buffalo NY 14210 Erie 7168598396

Danakas, George T. Obstetrics and Gynecology General Physician PC 268 Main St East Aurora NY 14052 Erie 7166528606

Danakas, George T. Obstetrics and Gynecology George Danakas 268 Main St East Aurora NY 14052 Erie 7166528606

Danakas, George T. Obstetrics and Gynecology General Physician PC 210 E Main St Springville NY 14141 Erie 7166528606

Danakas, George T. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy Buffalo NY 14224 Erie 7166464077

Danakas, George T. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Danakas, George T. Obstetrics and Gynecology General Physician PC 2072 Kensington Ave Buffalo NY 14226 Erie 7168834350

Danakas, George T. Obstetrics and Gynecology General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Danakas, George T. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Danakas, George T. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Davis, Judine C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621506

Davis, Judine C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912500

Dembski, Jennie L. Obstetrics and Gynecology Kaleida Health 3860 McKinley Pkwy Ste 210 Blasdell NY 14219 Erie 7167686622

Dembski, Jennie L. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Dembski, Jennie L. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787737

Dembski, Jennie L. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Dimopoulos, Polyxeni Obstetrics and Gynecology Audubon Womens Medical Assoc Pc 1360 N Forest Rd Ste 102 Williamsville NY 14221 Erie 7166394034

Dolensek, Christian B. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165686776

Dolensek, Christian B. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Dolensek, Christian B. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Dolensek, Christian B. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1315 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Dolensek, Christian B. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Dolensek, Christian B. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787263

Dolensek, Christian B. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Dolensek, Christian B. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Dolensek, Christian B. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Dolensek, Christian B. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Page 80 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Dsouza, Marcelino F. Obstetrics and Gynecology Amherst Ob/Gyn Associates PC 8750 Transit Rd Ste 205 East Amherst NY 14051 Erie 7166397970

Dsouza, Marcelino F. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Eddib, Abeer A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Eddib, Abeer A. Obstetrics and Gynecology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Ste 200 Cheektowaga NY 14225 Erie 7168445000

Eddib, Abeer A. Obstetrics and Gynecology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Eddib, Abeer A. Obstetrics and Gynecology Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168588422

Erk, Mehmet Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Erk, Mehmet Obstetrics and Gynecology Premier OB/GYN 8270 Wehrle Dr Williamsville NY 14221 Erie 7166318212

Erk, Susan C. Obstetrics and Gynecology Premier OB/GYN 8270 Wehrle Dr Williamsville NY 14221 Erie 7166318212

Eswar, Alexander N. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Eswar, Alexander N. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Falkner, Catherine M. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Falkner, Catherine M. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Falkner, Catherine M. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7166944500

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Farkash, Gil M. Obstetrics and Gynecology Women First Healthcare Of Wny Pc 240 Redtail Dr Ste 6 Orchard Park NY 14127 Erie 7166770454

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165686776

Farkash, Gil M. Obstetrics and Gynecology Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Farkash, Gil M. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Fazili, Sharifa Obstetrics and Gynecology Fazili, Sharifa 436 Linwood Ave Buffalo NY 14209 Erie 7168854118

Feldman, Donna A. Obstetrics and Gynecology Womens Medicine of Niagara PLLC 1801 Grand Island Blvd Ste 300 Grand Island NY 14072 Erie 7162979379

Ferro, Philip L. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Ferro, Philip L. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Fraas, Loriann Obstetrics and Gynecology Suburban Women's Healthcare 3620 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7168765512

Frech, Michele H. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Frech, Michele H. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Frech, Michele H. Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Frech, Michele H. Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Frech, Michele H. Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Gavin, Julie A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Gavin, Julie A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Gavin, Julie A. Obstetrics and Gynecology Julie A Gavin MD OBGYN PLLC 3800 Delaware Ave Ste 108 Kenmore NY 14217 Erie 7168739115

Gelman Koessler, Lisa A. Obstetrics and Gynecology Buffalo OBGYN, LLP 4575 Main St Buffalo NY 14226 Erie 7166334575

Gelman Koessler, Lisa A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Gelman Koessler, Lisa A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Ghomi, Ali Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168621965

Ghomi, Ali Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621966

Giotis, Margarita K. Obstetrics and Gynecology Giotis, Margarita 19 Limestone Dr Unit 7 Williamsville NY 14221 Erie 7166322028

Greene, Robert A. Obstetrics and Gynecology Cny Fertility Center 835 Hopkins Rd Williamsville NY 14221 Erie 3154698700

Griffin, Adam M. Obstetrics and Gynecology Infertility & IVF Medical Assoc 4510 Main St Buffalo NY 14226 Erie 7168393057

Gugino, Lawrence J. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 302 Buffalo NY 14220 Erie 7168283520

Gupta, Sangeeta Obstetrics and Gynecology Kaleida Health 462 Grider St Buffalo NY 14215 Erie 7168985544

Gupta, Sangeeta Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Gupta, Sangeeta Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Gupta, Sangeeta Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Habib, Farzana Obstetrics and Gynecology Frazana Habib 646 N French Rd Ste 1 Amherst NY 14228 Erie 7165682155

Hage, Douglas D. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Hage, Douglas D. Obstetrics and Gynecology Burns MD & Hage MD PC 7020 Erie Rd Derby NY 14047 Erie 7169474545

Harrington, Amy R. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Harrington, Amy R. Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Hellriegel Jr, John C. Obstetrics and Gynecology Hellriegel, John 4949 Harlem Rd Amherst NY 14226 Erie 7168398010

Hellriegel Jr, John C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621984

Hellriegel Jr, John C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912500

Hellriegel Jr, John C. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Hellriegel Jr, John C. Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Southtowns Womens Group Hamburg NY 14075 Erie 7166484345

Hellriegel Jr, John C. Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Hellriegel Jr, John C. Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Hellriegel Jr, John C. Obstetrics and Gynecology Hellriegel, John 449 Brantwood Rd Buffalo NY 14226 Erie 7168383209

Hoebel, Robin S. Obstetrics and Gynecology Audubon Womens Medical Assoc Pc 1360 N Forest Rd Buffalo NY 14221 Erie 7166394034

Jain, Charu K. Obstetrics and Gynecology Lake Erie Medical Services, PC 826 Lake St Angola NY 14006 Erie 7166722000

Johnson, Jeffrey R. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Johnson, Jeffrey R. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Page 81 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Johnson, Jeffrey R. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168781227

Johnson, Jeffrey R. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Johnson, Jeffrey R. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Justicia Linde, Faye E. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787737

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 100 High St BGH Womens Health Center Buffalo NY 14203 Erie 7168591098

Justicia Linde, Faye E. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1150 Youngs Rd Ste 208 Williamsville NY 14221 Erie 7166369112

Justicia Linde, Faye E. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1315 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Justicia Linde, Faye E. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787738

Kanaan, Camille M. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168781227

Kanaan, Camille M. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Kanaan, Camille M. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Khulpateea, Beman R. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168874600

Khurana, Dalip K. Obstetrics and Gynecology Khurana, Dalip 25 E Main St Ste 5 Springville NY 14141 Erie 7165924166

Khurana, Dalip K. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Khurana, Dalip K. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 3040 Amsdell Rd Ste 201B Hamburg NY 14075 Erie 7166486539

Kirakosyan, Armen A. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Kirakosyan, Armen A. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 268 Main St East Aurora NY 14052 Erie 7166528606

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Kirakosyan, Armen A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 2072 Kensington Ave Buffalo NY 14226 Erie 7168834350

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Kirakosyan, Armen A. Obstetrics and Gynecology General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Koritz, Sara H. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Koritz, Sara H. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Koritz, Sara H. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Kraft, Jane D. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kraft, Jane D. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Kraft, Jane D. Obstetrics and Gynecology Jane D Kraft MD PLLC 21 E Main St Springville NY 14141 Erie 7165928931

Kraft, Jane D. Obstetrics and Gynecology Mercy Hospital 27 Franklin St Ste 1 Springville NY 14141 Erie 7165927400

Lajeunesse, Suzette M. Obstetrics and Gynecology Buffalo Medical Group 2121 Main St Ste 305 Buffalo NY 14214 Erie 7166301150

Lajeunesse, Suzette M. Obstetrics and Gynecology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301150

Lana, Rosann L. Obstetrics and Gynecology Buffalo OBGYN, LLP 4575 Main St Buffalo NY 14226 Erie 7166334575

Lana, Rosann L. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Lana, Rosann L. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Lauria, Philip G. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lauria, Philip G. Obstetrics and Gynecology Hamburg Gyn & Ob Group 4154 McKinley Pkwy Ste 1200 Blasdell NY 14219 Erie 7166496500

Lawler, Jack R. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1540 Maple Rd Ste 25 Williamsville NY 14221 Erie 7165686572

Lawler, Jack R. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621506

Lawler, Jack R. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168283650

Lawler, Jack R. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787861

Lee, Ji Young Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Lee, Ji Young Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Lee, Ji Young Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Lee, Ji Young Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Lee, Ji Young Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168921984

Lele, Amol S. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787861

Lele, Amol S. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787263

Lele, Amol S. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Lipford, Benita P. Obstetrics and Gynecology Kaleida Health 1313 Main St Buffalo NY 14209 Erie 7167484988

Littler, Susan J. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Littler, Susan J. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Liu, Cici S. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Liu, Cici S. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Liu, Cici S. Obstetrics and Gynecology Kaleida Health 239 Bryant St Ste 295D Buffalo NY 14222 Erie 7168787737

Majid, Tawsufe Obstetrics and Gynecology Lake Erie Medical Services, PC 826 Lake St Angola NY 14006 Erie 7166722000

Malik, Shaveta Obstetrics and Gynecology Kaleida Health 239 Bryant St Ste 295D Buffalo NY 14222 Erie 7168787737

Malik, Shaveta Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Malik, Shaveta Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Page 82 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Malik, Shaveta Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Mas, Eddie E. Obstetrics and Gynecology Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Mas, Eddie E. Obstetrics and Gynecology Mas, Eddie 172 Slade Ave West Seneca NY 14224 Erie 7168233300

Mas, Eddie E. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

McColgin, Sterling W. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7188781227

McColgin, Sterling W. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

McDonnell, Margaret P. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912500

McDonnell, Margaret P. Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

McDonnell, Margaret P. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621506

McDonnell, Margaret P. Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

McDonnell, Margaret P. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

McDonnell, Margaret P. Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Mechtler, Stephen A. Obstetrics and Gynecology Snyder Ob-Gyn PC 3980 Sheridan Dr Ste 400 Amherst NY 14226 Erie 7169292600

Melanson, Julia D. Obstetrics and Gynecology Buffalo Medical Group 6245 Sheridan Dr Williamsville NY 14221 Erie 7166301150

Melanson, Julia D. Obstetrics and Gynecology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301150

Melanson, Julia D. Obstetrics and Gynecology Buffalo Medical Group 2121 Main St Ste 305 Buffalo NY 14214 Erie 7166301150

Morrison, Diane H. Obstetrics and Gynecology Diane H Morrison Md 37 Maple Rd Williamsville NY 14221 Erie 7165650352

Morrison, Katharine V. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Morrison, Katharine V. Obstetrics and Gynecology Katharine Morrison MD PLLC 2500 Main St Buffalo NY 14214 Erie 7168352510

Naik, Ashok P. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Naik, Ashok P. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7165686725

Naik, Ashok P. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Novotny, Margaret A. Obstetrics and Gynecology Novotny, Margaret 6161 Transit Rd Ste 4 East Amherst NY 14051 Erie 7163321166

Nylander, Emmekunla K. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621759

Nylander, Emmekunla K. Obstetrics and Gynecology Buffalo OBGYN, LLP 4575 Main St Amherst NY 14226 Erie 7166334575

Nylander, Emmekunla K. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Nylander, Emmekunla K. Obstetrics and Gynecology Buffalo OBGYN, LLP 85 Wehrle Dr Cheektowaga NY 14225 Erie 7166334575

Obst, Jaime R. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Ortman Nabi, Judith A. Obstetrics and Gynecology All Care for Women Ob/Gyn 6095 Transit Rd East Amherst NY 14051 Erie 7166349303

Ortman Nabi, Judith A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Osman, Magda G. Obstetrics and Gynecology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301150

Osman, Magda G. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Osman, Magda G. Obstetrics and Gynecology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301150

Osman, Magda G. Obstetrics and Gynecology Buffalo Medical Group 2121 Main St Ste 305 Buffalo NY 14214 Erie 7166301150

Osman, Magda G. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Osman, Magda G. Obstetrics and Gynecology Buffalo Medical Group 6245 Sheridan Dr Ste 316 Williamsville NY 14221 Erie 7166301150

Paczos, Tamera A. Obstetrics and Gynecology University at Buffalo Pathologists PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Paczos, Tamera A. Obstetrics and Gynecology University at Buffalo Pathologists PC 115 Flint Rd Williamsville NY 14221 Erie 7166267200

Paczos, Tamera A. Obstetrics and Gynecology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Paczos, Tamera A. Obstetrics and Gynecology University at Buffalo Pathologists PC 3 Gates Circle Buffalo NY 14209 Erie 7168874600

Paczos, Tamera A. Obstetrics and Gynecology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Paczos, Tamera A. Obstetrics and Gynecology University at Buffalo Pathologists PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Paolucci, Patrice R. Obstetrics and Gynecology Womens Medicine of Niagara PLLC 1801 Grand Island Blvd Ste 300 Grand Island NY 14072 Erie 7162979379

Penvose Yi, Jan R. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Pieczonka, Sheila M. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Pieczonka, Sheila M. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Pieczonka, Sheila M. Obstetrics and Gynecology Santos, Carlos 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Pivarunas, Anthony R. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Pivarunas, Anthony R. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912500

Pivarunas, Anthony R. Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Pivarunas, Anthony R. Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Pivarunas, Anthony R. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621965

Pivarunas, Anthony R. Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Polcaro, Joseph Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Polcaro, Joseph Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Polcaro, Joseph Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 204 Buffalo NY 14220 Erie 7168283650

Powalski Jr, Robert J. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 6440 Transit Rd Depew NY 14043 Erie 7166845454

Powalski Jr, Robert J. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 3834 Delaware Ave Kenmore NY 14217 Erie 7168771221

Press, Shalom Obstetrics and Gynecology Press, Shalom 2550 Sweet Home Rd Buffalo NY 14228 Erie 7166911414

Rayner, Laura J. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Rayner, Laura J. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Rayner, Laura J. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Rayner, Laura J. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Rayner, Laura J. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Rayner, Laura J. Obstetrics and Gynecology General Physician PC 268 Main St East Aurora NY 14052 Erie 7166528606

Rayner, Laura J. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Page 83 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Rayner, Laura J. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Rayner, Laura J. Obstetrics and Gynecology General Physician PC 2072 Kensington Pkwy Buffalo NY 14226 Erie 7168834350

Rayner, Laura J. Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd East Amherst NY 14051 Erie 7166368284

Rayner, Laura J. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Rayner, Laura J. Obstetrics and Gynecology General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Reid, Emerson C. Obstetrics and Gynecology Reid, Emerson 1832 Main St Buffalo NY 14208 Erie 7168857088

Rojek, Jennifer L. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Rojek, Jennifer L. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rojek, Jennifer L. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Lancaster NY 14043 Erie 7166755222

Ruckert IV, G Theodore Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Ruckert IV, G Theodore Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Rush, Theresa A. Obstetrics and Gynecology Audubon Womens Medical Assoc Pc 1360 N Forest Rd Williamsville NY 14221 Erie 7166394034

Rush, Theresa A. Obstetrics and Gynecology Kaleida Health 1360 N Forest Rd Ste 102 Williamsville NY 14221 Erie 7166394034

Samad, Afshan Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166755222

Samad, Afshan Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Samadi, Dilara E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Samadi, Dilara E. Obstetrics and Gynecology Buffalo Medical Group 2121 Main St Ste 305 Buffalo NY 14214 Erie 7166301150

Samadi, Dilara E. Obstetrics and Gynecology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301130

Samadi, Dilara E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7166301150

Samadi, Dilara E. Obstetrics and Gynecology Buffalo Medical Group 6245 Sheridan Dr Ste 316 Williamsville NY 14221 Erie 7166301150

Sanfilippo, Diane M. Obstetrics and Gynecology Diane M Sanfilippo MD OB GYN PC 410 Abbott Rd Buffalo NY 14220 Erie 7168274850

Santhakumar, Lata Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Santhakumar, Lata Obstetrics and Gynecology Erie County Medical Center 608 William St Buffalo NY 14206 Erie 7168588422

Santhakumar, Lata Obstetrics and Gynecology Kaleida Health 100 High St BGH Womens Health Center Buffalo NY 14203 Erie 7168591098

Santhakumar, Lata Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787263

Santhakumar, Lata Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Santhakumar, Lata Obstetrics and Gynecology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Santhakumar, Lata Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1150 Youngs Rd Ste 208 Buffalo NY 14221 Erie 7166369112

Santhakumar, Lata Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787737

Santhakumar, Lata Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1315 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Santhakumar, Lata Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Santos, Carlos A. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Santos, Carlos A. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Santos, Carlos A. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Sayegh, Magdi E. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Sayegh, Magdi E. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787737

Sayegh, Magdi E. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Sayegh, Magdi E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 30 N Union Rd Ste 101 Buffalo NY 14221 Erie 7166336363

Sayegh, Magdi E. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166336363

Sayegh, Magdi E. Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Sayegh, Magdi E. Obstetrics and Gynecology Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Sayegh, Magdi E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Sayegh, Magdi E. Obstetrics and Gynecology Chouchani & Sayegh Md Llp 2780 Delaware Ave Ste 204 Buffalo NY 14217 Erie 7162598220

Sayegh, Magdi E. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Shah, Noor M. Obstetrics and Gynecology Shah, Noor 2695 Harlem Rd Cheektowaga NY 14225 Erie 7168915991

Shaman, Majid Obstetrics and Gynecology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Shaman, Majid Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Shaman, Majid Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787861

Shaman, Majid Obstetrics and Gynecology Kaleida Health 239 Bryant St WCHOB Womens Health Center Buffalo NY 14222 Erie 7168787738

Shaman, Majid Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Shaman, Majid Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1150 Youngs Rd Ste 208 Buffalo NY 14221 Erie 7166369112

Shaman, Majid Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Shaman, Majid Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Shaman, Majid Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1315 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Sheth, Ashwina G. Obstetrics and Gynecology Erie County Medical Center 1500 Broadway Ave Buffalo NY 14212 Erie 7168320618

Sheth, Ashwina G. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Sheth, Ashwina G. Obstetrics and Gynecology Ashwina Sheth Md Gaurang S Sheth Md 85 Wehrle Dr Cheektowaga NY 14225 Erie 7168320618

Sheth, Ashwina G. Obstetrics and Gynecology Ashwina Sheth Md Gaurang S Sheth Md 585 Delaware Ave Tonawanda NY 14150 Erie 7166934400

Sheth, Ashwina G. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621982

Smith, Brian G. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Smith, Brian G. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Smith, Brian G. Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Smyers, Kristen L. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 6440 Transit Rd Depew NY 14043 Erie 7166845454

Smyers, Kristen L. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 3834 Delaware Ave Kenmore NY 14217 Erie 7168771221

Snell Garus, Karen A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Buffalo NY 14221 Erie 7166944500

Snell Garus, Karen A. Obstetrics and Gynecology Mercy Hospital 227 Ridge Rd Lackawanna NY 14218 Erie 7168225944

Page 84 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Snell Garus, Karen A. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Snell Garus, Karen A. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Snell Garus, Karen A. Obstetrics and Gynecology Novotny, Margaret 6161 Transit Rd East Amherst NY 14051 Erie 7163321166

Snell Garus, Karen A. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Snell Garus, Karen A. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Sorley Mastrodomen, Rebecca E. Obstetrics and Gynecology Kaleida Health 1360 N Forest Rd Ste 102 Buffalo NY 14221 Erie 7166394034

Sorley Mastrodomen, Rebecca E. Obstetrics and Gynecology Audubon Womens Medical Assoc Pc 1360 N Forest Rd Ste 102 Buffalo NY 14221 Erie 7166394034

Strittmatter, Chad A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621984

Strittmatter, Chad A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912500

Strittmatter, Chad A. Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Strittmatter, Chad A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Strittmatter, Chad A. Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7166484345

Strittmatter, Chad A. Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Strollo, Nina M. Obstetrics and Gynecology Suburban Women's Healthcare 3620 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7168765512

Swenson, Krista M. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Szczepanski, Jamie L. Obstetrics and Gynecology General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Szczepanski, Jamie L. Obstetrics and Gynecology General Physician PC 2072 Kensington Ave Buffalo NY 14226 Erie 7168834350

Szczepanski, Jamie L. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Szczepanski, Jamie L. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Szczepanski, Jamie L. Obstetrics and Gynecology General Physician PC 268 Main St East Aurora NY 14052 Erie 7166528606

Szczepanski, Jamie L. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Taylor, Martina Obstetrics and Gynecology Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Taylor, Martina Obstetrics and Gynecology Northwest Buffalo Community Health 3674 Commerce Pl Hamburg NY 14075 Erie 7168752904

Taylor, Martina Obstetrics and Gynecology Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Thota, Sharmilee Obstetrics and Gynecology Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Thota, Sharmilee Obstetrics and Gynecology Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Thota, Sharmilee Obstetrics and Gynecology Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Thota, Sharmilee Obstetrics and Gynecology Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Thota, Sharmilee Obstetrics and Gynecology Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Todoro, Carmen M. Obstetrics and Gynecology Mercy Hospital 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7168283520

Todoro, Carmen M. Obstetrics and Gynecology OB/Gyn Associates of Western New York 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166755222

Todoro, Carmen M. Obstetrics and Gynecology OB/Gyn Associates of Western New York 4845 Transit Rd Depew NY 14043 Erie 7166562200

Todoro, Carmen M. Obstetrics and Gynecology Mercy Hospital 565 Abbot Rd Buffalo NY 14220 Erie 7168267000

Touchan, Faraj Obstetrics and Gynecology Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Touchan, Faraj Obstetrics and Gynecology Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Touchan, Faraj Obstetrics and Gynecology Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Touchan, Faraj Obstetrics and Gynecology Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Touchan, Faraj Obstetrics and Gynecology Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Trevett, Millicent H. Obstetrics and Gynecology Suburban Women's Healthcare 3620 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7168765512

Walsh, Andrea H. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Weissman, Mark A. Obstetrics and Gynecology Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Weissman, Mark A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Weissman, Mark A. Obstetrics and Gynecology Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Weissman, Mark A. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 3834 Delaware Ave Kenmore NY 14217 Erie 7168771221

Weissman, Mark A. Obstetrics and Gynecology Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Weissman, Mark A. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Weissman, Mark A. Obstetrics and Gynecology Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Weissman, Mark A. Obstetrics and Gynecology Bartels Powalski & Weissman Md Pc 6440 Transit Rd Depew NY 14043 Erie 7166845454

Weissman, Mark A. Obstetrics and Gynecology Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Weppner, Dennis M. Obstetrics and Gynecology Weppner, Dennis 6044 Main St Buffalo NY 14221 Erie 7166341702

Weppner, Dennis M. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787861

Weppner, Dennis M. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Weppner, Dennis M. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Weselak, Rachel G. Obstetrics and Gynecology Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Weselak, Rachel G. Obstetrics and Gynecology Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Weselak, Rachel G. Obstetrics and Gynecology Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Weselak, Rachel G. Obstetrics and Gynecology Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Weselak, Rachel G. Obstetrics and Gynecology Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

West, Threvia Obstetrics and Gynecology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Williams, Emily F. Obstetrics and Gynecology General Physician PC 1185 Sweet Home Rd Amherst NY 14226 Erie 7166564077

Williams, Emily F. Obstetrics and Gynecology General Physician PC 120 Gardenville Pkwy West Seneca NY 14224 Erie 7166564077

Williams, Emily F. Obstetrics and Gynecology General Physician PC 899 Main St Buffalo NY 14203 Erie 7166564077

Williams, Emily F. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166334575

Williams, Emily F. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Williams, Emily F. Obstetrics and Gynecology Buffalo OBGYN, LLP 4575 Main St Amherst NY 14226 Erie 7166334575

Wopperer, Paul J. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621502

Page 85 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Wopperer, Paul J. Obstetrics and Gynecology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Wopperer, Paul J. Obstetrics and Gynecology Paul J Wopprer Md 5214 Main St Ste 100 Williamsville NY 14221 Erie 7165653620

Yu, Taechin Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Yu, Taechin Obstetrics and Gynecology Northtown Obgyn PC 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Yu, Taechin Obstetrics and Gynecology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Yu, Taechin Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 2697 Main St Buffalo NY 14214 Erie 7168312200

Yu, Taechin Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 6161 Transit Rd Ste 5 East Amherst NY 14051 Erie 7166368284

Yu, Taechin Obstetrics and Gynecology Planned Parenthood of Central and Western New York Inc 240 Center Rd West Seneca NY 14224 Erie 7168312200

Yu, Taechin Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787737

Yu, Taechin Obstetrics and Gynecology Northtown Obgyn PC 2730 Union Rd Cheektowaga NY 14227 Erie 7166681188

Yu, Taechin Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Yu, Taechin Obstetrics and Gynecology University Gynecologists & Obstetriciansstate Universit 1319 Jefferson Ave Buffalo NY 14208 Erie 7162428327

Zornek Jr, Nicholas F. Obstetrics and Gynecology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168874600

Zornek Jr, Nicholas F. Obstetrics and Gynecology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165686776

Zornek Jr, Nicholas F. Obstetrics and Gynecology Kaleida Health 239 Bryant St Buffalo NY 14222 Erie 7168787738

Alterio, Christopher J. Occupational Therapy ABC Therapeutics Occupational & Physical Therapy 11390 Transit Rd East Amherst NY 14051 Erie 7165803040

Ball, Jennifer A. Occupational Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Bingel, Erin M. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Bingel, Erin M. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Brown, Alison Occupational Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Caputi, Melissa Occupational Therapy Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Caputi, Melissa Occupational Therapy Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Casolini Dal Bo, Jennifer M. Occupational Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 4949 Harlem Rd Amherst NY 14226 Erie 7166315224

Casolini Dal Bo, Jennifer M. Occupational Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 3940 California Rd Orchard Park NY 14127 Erie 7166315224

Casolini Dal Bo, Jennifer M. Occupational Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 5144 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7166315224

Casolini Dal Bo, Jennifer M. Occupational Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168403380

Chamoun, Apryl M. Occupational Therapy Chamoun, Apryl 1275 Delaware Ave Ste 300 Buffalo NY 14209 Erie 7168810499

Colegrove, Rachel R. Occupational Therapy Rundquist, John 3070 Transit Rd West Seneca NY 14224 Erie 7166681166

Courier, Marcia L. Occupational Therapy Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Courier, Marcia L. Occupational Therapy Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Felser, Kathleen M. Occupational Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Giancola, Marianne L. Occupational Therapy Giancola, Marianne 8672 Main St Williamsville NY 14221 Erie 7165314391

Gibson, Troy D. Occupational Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 3940 California Rd Orchard Park NY 14127 Erie 7166315224

Gibson, Troy D. Occupational Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 4949 Harlem Rd Amherst NY 14226 Erie 7166315224

Gibson, Troy D. Occupational Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 5144 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7166315224

Gibson, Troy D. Occupational Therapy Gibson, Troy D. 5144 Sheridan Dr Ste 2 Buffalo NY 14221 Erie 7166315224

Jachlewski, Jennifer M. Occupational Therapy Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Johnson, Leah M. Occupational Therapy Autumn View Health Care Facility LLC S4650 Southwestern Blvd Hamburg NY 14075 Erie 7168262010

Johnson, Leah M. Occupational Therapy Adams, Ronald S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Kaminski, Sandra J. Occupational Therapy Weston Paxxon PT OT & SLP PLLC 245 Bassett Rd Williamsville NY 14221 Erie 7166980359

Kaminski, Sandra J. Occupational Therapy Weston Paxxon PT OT & SLP PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Kirisits, Mary Ann Occupational Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Koenig, Elizabeth M. Occupational Therapy Harris Hill Nursing Facility 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Kong, Anisa C. Occupational Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Krebs, Rachel M. Occupational Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162506500

Kunda, Nicole Y. Occupational Therapy Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Kunda, Nicole Y. Occupational Therapy Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Kunda, Nicole Y. Occupational Therapy Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Leitten, Ann M. Occupational Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Lucker, Gloria R. Occupational Therapy Optimal Occupational and Physical Therapy Associates Se 2495 Main St Ste 234 Buffalo NY 14214 Erie 7168365929

Malikowski, Sara A. Occupational Therapy Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Malikowski, Sara A. Occupational Therapy Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Malikowski, Sara A. Occupational Therapy Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Marioles, Teresa M. Occupational Therapy Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Marioles, Teresa M. Occupational Therapy Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Michalski, Karyn M. Occupational Therapy Weston Paxxon PT OT & SLP PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Michalski, Karyn M. Occupational Therapy PRN Physical & Occupational Therapy Network PLLC 6363 Transit Rd East Amherst NY 14051 Erie 7166885709

Michalski, Karyn M. Occupational Therapy Weston Paxxon PT OT & SLP PLLC 245 Bassett Rd Williamsville NY 14221 Erie 7166980359

Pandolfino, Colleen M. Occupational Therapy Autumn View Health Care Facility LLC S4650 Southwestern Blvd Hamburg NY 14075 Erie 7168262010

Pandolfino, Colleen M. Occupational Therapy Adams, Ronald S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Pinkoski, Dani Lyn M. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Pinkoski, Dani Lyn M. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Przybyl, Lisa M. Occupational Therapy Western New York Physical And Occupational Therapy 162 Mill St Williamsville NY 14221 Erie 7166318081

Przybyl, Lisa M. Occupational Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Przybyl, Lisa M. Occupational Therapy Western New York Physical And Occupational Therapy 2700 N Forest Rd Ste 101 Getzville NY 14068 Erie 7166393330

Przybyl, Lisa M. Occupational Therapy Western New York Physical And Occupational Therapy 545 Delaware St Tonawanda NY 14150 Erie 7166945385

Page 86 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Przybyl, Lisa M. Occupational Therapy Western New York Physical And Occupational Therapy 12395 Olean Rd Chaffee NY 14030 Erie 7164965550

Romans, Alissa A. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Romans, Alissa A. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Russo, Cynthia Occupational Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Schmidt, Nicole M. Occupational Therapy ABC Therapeutics Occupational & Physical Therapy 11390 Transit Rd East Amherst NY 14051 Erie 7165803040

Schneider, Jennifer M. Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719915

Scott, Nikole L. Occupational Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Senneff, Kristin M. Occupational Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Siracuse, Tracy L. Occupational Therapy Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Siracuse, Tracy L. Occupational Therapy Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Swain, Roxanne S. Occupational Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Sweeney, Jonathan T. Occupational Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Vranich, Kathryn M. Occupational Therapy The Resource Center 101 Oak St Buffalo NY 14203 Erie 7168564204

Weixlmann, Jeanine M. Occupational Therapy Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Yager, Jo Ann Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Yager, Jo Ann Occupational Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Gibbs, John F. Oncology Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168597629

Albanese, Umberto Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Albanese, Umberto Ophthalmology Albanese, Umberto 220 Red Tail Ste 3 Orchard Park NY 14127 Erie 7166313300

Albanese, Umberto Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Albanese, Umberto Ophthalmology Albanese, Umberto 6480 Main St Ste 1 Williamsville NY 14221 Erie 7166313300

Albanese, Umberto Ophthalmology University Opthalmology Services Inc 3580 Sheridan Rd Ste 150 Amherst NY 14226 Erie 7168817900

Albanese, Umberto Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Anthone, Kenneth D. Ophthalmology Eye Health Associates of WNY PC dba Anthone Eye Center 2211 Sheridan Dr Tonawanda NY 14223 Erie 7166346100

Anthone, Kenneth D. Ophthalmology Eye Health Associates of WNY PC dba Anthone Eye Center 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Antonucci, Louis J. Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Armenia, Donald J. Ophthalmology Donald J Armenia MD PC 3723 Seneca St West Seneca NY 14224 Erie 7166755000

Atwal, Amarjit S. Ophthalmology Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Atwal, Ephraim S. Ophthalmology Amar Atwal MD PC 3095 Harlem Rd Buffalo NY 14225 Erie 7168968831

Awner, Steven Ophthalmology Steven Awner 3980 Sheridan Dr Ste 402 Buffalo NY 14226 Erie 7162044516

Awner, Steven Ophthalmology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787567

Berardi, Joseph R. Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Boscarino, Martin A. Ophthalmology Martin A Boscarino MD 6480 Main St Ste 1 Williamsville NY 14221 Erie 7166313300

Boscarino, Martin A. Ophthalmology Martin A Boscarino MD 220 Redtail Rd Ste 3 Orchard Park NY 14127 Erie 7166743600

Bruno, Maria D. Ophthalmology Donald J Armenia MD PC 3723 Seneca St West Seneca NY 14224 Erie 7166755000

Campbell, Michael O. Ophthalmology A Schlisserman Md 3151 Southwestern Blvd Orchard Park NY 14127 Erie 7166746030

Cotter, Daniel M. Ophthalmology Eye Care & Vision Associates 932 Elmwood Ave Buffalo NY 14222 Erie 7168840880

Cotter, Daniel M. Ophthalmology Eye Care & Vision Associates 1 Hopkins Rd Williamsville NY 14221 Erie 7166318888

Crofts, John W. Ophthalmology Crofts, John 4763 Main St Amherst NY 14226 Erie 7168392610

Crofts, John W. Ophthalmology Erie County Medical Center 462 Grider St Rm 133 Buffalo NY 14215 Erie 7168983316

Dusse, Jon L. Ophthalmology Buffalo Medical Group 6245 Sheridan Dr Williamsville NY 14221 Erie 7168578604

Dusse, Jon L. Ophthalmology Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Dusse, Jon L. Ophthalmology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578604

Elmer Jr, Thomas R. Ophthalmology Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Elmer Jr, Thomas R. Ophthalmology Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Elmer Jr, Thomas R. Ophthalmology Fichte Eye Associates Pc 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Elmer Jr, Thomas R. Ophthalmology Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Endl II, Michael J. Ophthalmology Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Endl II, Michael J. Ophthalmology Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Endl II, Michael J. Ophthalmology Fichte Eye Associates Pc 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Epstein, Barry M. Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Epstein, Barry M. Ophthalmology Epstein, Barry 606 N French Rd Ste 3 4 West Amherst NY 14228 Erie 7166880996

Everett, Sandra L. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Everett, Sandra L. Ophthalmology Surgical Associates Of Western Ny Pc A103 550 Orchard Pk Rd Buffalo NY 14224 Erie 7166775500

Everett, Sandra L. Ophthalmology Everett, Sandra 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Everett, Sandra L. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Everett, Sandra L. Ophthalmology Everett, Sandra 462 Grinder St Buffalo NY 14215 Erie 7168983931

Everett, Sandra L. Ophthalmology Everett, Sandra 3085 Southwestern Blvd Orchard Park NY 14127 Erie 7166743600

Everett, Sandra L. Ophthalmology University Orthopaedics Services Inc 215 Klein Rd Williamsville NY 14221 Erie 7165686100

Everett, Sandra L. Ophthalmology Everett, Sandra 220 Red Tail Rd Ste 3 Orchard Park NY 14127 Erie 7168390884

Everett, Sandra L. Ophthalmology Everett, Sandra 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Everett, Sandra L. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Everett, Sandra L. Ophthalmology Everett, Sandra 550 Orchard Park Rd West Seneca NY 14224 Erie 7166774400

Everett, Sandra L. Ophthalmology Everett, Sandra 338 Harris Hill Rd Ste 207 Williamsville NY 14221 Erie 7166344798

Everett, Sandra L. Ophthalmology NK Optical LLC 4245 Union Rd Ste 105 Cheektowaga NY 14225 Erie 7166342678

Fichte, Claus M. Ophthalmology Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Page 87 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Fichte, Claus M. Ophthalmology Fichte Eye Associates Pc 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Fichte, Claus M. Ophthalmology Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Fitzgerald Farkas, Ellen C. Ophthalmology Niswander Eye Center Philip Niswander Md 40 N Union Rd Williamsville NY 14221 Erie 7166344441

Flanigen, Diane T. Ophthalmology Diane Flanigen MD Eye Care PC 1835 Maple Rd Williamsville NY 14221 Erie 7166912900

Forell Tomasulo, Cheryl A. Ophthalmology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Forgach, Peter W. Ophthalmology Forgach, Peter 405 International Dr Williamsville NY 14221 Erie 7163667386

Gulati, Ashvani K. Ophthalmology The Optical Store 3750 Delaware Ave Kenmore NY 14217 Erie 7168742455

Gulati, Ashvani K. Ophthalmology Ashvani Gulati 3750 Delaware Ave Kenmore NY 14217 Erie 7168742455

Gurevich, Leonard Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166676500

Gurevich, Leonard Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Gurevich, Leonard Ophthalmology Leonard Gurevich Md Pc Dba Western New 27 Franklin St Springville NY 14141 Erie 7165925006

Gurevich, Leonard Ophthalmology Leonard Gurevich Md Pc Dba Western New 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Guttuso, Thomas J. Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Holmwood, Paul C. Ophthalmology Eye Care & Vision Associates 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7166485329

Holmwood, Paul C. Ophthalmology Eye Care & Vision Associates 1 Hopkins Rd Williamsville NY 14221 Erie 7166318888

Hurley, Peter E. Ophthalmology Oculofacial Plastic Surgery of WNY PLLC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Hurley, Peter E. Ophthalmology Oculofacial Plastic Surgery of WNY PLLC 5800 Main St Williamsville NY 14221 Erie 7169327670

Imbrogno, Vincent M. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Imbrogno, Vincent M. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7169326064

Jermak, Christopher M. Ophthalmology Faruk M Koreishi Md Pc 6637 Main St Williamsville NY 14221 Erie 7166321595

Jermak, Christopher M. Ophthalmology Faruk M Koreishi Md Pc 3055 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7167122440

Jung, Hoon C. Ophthalmology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168627461

Khan, Mehdi Ophthalmology Faruk M Koreishi Md Pc 6637 Main St Williamsville NY 14221 Erie 7166321595

Khan, Mehdi Ophthalmology Faruk M Koreishi Md Pc 3055 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7167122440

Knapp, Russell G. Ophthalmology Russell G Knapp Md 1890 Colvin Blvd Tonawanda NY 14150 Erie 7168375200

Koreishi, Faruk M. Ophthalmology Faruk M Koreishi Md Pc 3055 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7167122440

Koreishi, Faruk M. Ophthalmology Faruk M Koreishi Md Pc 6637 Main St Williamsville NY 14221 Erie 7166321595

Kumar, Asha Ophthalmology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Kumar, Asha Ophthalmology Kumar, Asha 501 Kenmore Ave Buffalo NY 14223 Erie 7168385162

Lee, Henry C. Ophthalmology Henry Lee MD. PC 6480 Main St Ste 1 Williamsville NY 14221 Erie 7166313300

Lee, Henry C. Ophthalmology Henry Lee MD. PC 220 Red Tail Rd Ste 3 Orchard Park NY 14127 Erie 7166743600

Lee, Paul J. Ophthalmology Faruk M Koreishi Md Pc 6637 Main St Williamsville NY 14221 Erie 7166321595

Lee, Paul J. Ophthalmology Faruk M Koreishi Md Pc 3055 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7167122440

Legarreta, Edward A. Ophthalmology Edward A Legarreta MD 2720 Union Rd Cheektowaga NY 14227 Erie 7166683030

Legarreta, Edward A. Ophthalmology Edward A Legarreta MD 1301 N Forest Rd Ste 7 Williamsville NY 14221 Erie 7166332203

Lema, Gareth M. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Lema, Gareth M. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168341113

Lema, Gareth M. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Lema, Gareth M. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Lepie, Richard M. Ophthalmology Lepie, Richard 405 International Dr Williamsville NY 14221 Erie 7168851700

Lim Soh, Hyun J. Ophthalmology Lim-Soh, Hyun 290 Center Rd Buffalo NY 14224 Erie 7166742393

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 3 Gates Cir Buffalo NY 14205 Erie 7168875410

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7167483101

Lincoff Cohen, Norah S. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168320643

Lincoff Cohen, Norah S. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 100 High St E2 Buffalo NY 14203 Erie 7168597507

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Lincoff Cohen, Norah S. Ophthalmology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 300 Essjay Rd Williamsville NY 14221 Erie 7169326080

Lincoff Cohen, Norah S. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Lincoff Cohen, Norah S. Ophthalmology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Lundergan, Maureen K. Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Mattern, Ruth M. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Mattern, Ruth M. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14222 Erie 7169326064

Mattern, Ruth M. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Mattern, Ruth M. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Medina, Rafael R. Ophthalmology Rafael Medina MD PLLC 6044 Main St Ste 106 Williamsville NY 14221 Erie 7166350230

Montesanti, David P. Ophthalmology Eye Care & Vision Associates 932 Elmwood Ave Buffalo NY 14222 Erie 7168840880

Montesanti, David P. Ophthalmology Eye Care & Vision Associates 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7166485329

Murphy, Joseph A. Ophthalmology Western New York Retina 5225 Sheridan Dr Buffalo NY 14221 Erie 7162045440

Neal, Melissa A. Ophthalmology Twenty 20 Eyecare & Aesthetic Oculopast 410 Elmwood Ave Buffalo NY 14222 Erie 7164625437

Niles, Charles R. Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Niswander, Philip R. Ophthalmology Niswander Eye Center Philip Niswander Md 40 N Union Rd Buffalo NY 14221 Erie 7166344441

Noel, Marie Eve C. Ophthalmology Marie-Eve C Thoman 101 Treehaven Ln Elma NY 14059 Erie 7168968831

Page 88 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Noel, Marie Eve C. Ophthalmology Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Notaro Rietz, Saralyn Ophthalmology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Notaro Rietz, Saralyn Ophthalmology Buffalo Emergency Associates 55 Melroy Ave Lackawanna NY 14218 Erie 7168258000

Notaro Rietz, Saralyn Ophthalmology Saralyn Notaro MD 4476 Main St Ste 114 Buffalo NY 14226 Erie 7168399009

Notaro Rietz, Saralyn Ophthalmology Notaro-Rietz, Saralyn 207 Commerce Dr Amherst NY 14228 Erie 7166891901

Notaro Rietz, Saralyn Ophthalmology Notaro-Rietz, Saralyn 4476 Main St Ste 114 Buffalo NY 14226 Erie 7168399009

Pace, Lynne H. Ophthalmology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Patel, Dilipkumar J. Ophthalmology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Patel, Dilipkumar J. Ophthalmology Patel, Dilipkumar 65 Wehrle Dr Buffalo NY 14225 Erie 7168371090

Patel, Sangita P. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Patel, Sangita P. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Patel, Sangita P. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Patel, Sangita P. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Paulus, Peter Ophthalmology Paulus, Peter 13500 Broadway PO Box 298 Alden NY 14004 Erie 7169378796

Paulus, Peter Ophthalmology Eye Health Associates of WNY PC dba Anthone Eye Center 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Paulus, Peter Ophthalmology Eye Health Associates of WNY PC dba Anthone Eye Center 2211 Sheridan Dr Tonawanda NY 14223 Erie 7166346100

Pfohl, George W. Ophthalmology Eye Care & Vision Associates 932 Elmwood Ave Buffalo NY 14222 Erie 7168840880

Pfohl, George W. Ophthalmology Eye Care & Vision Associates 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7166485329

Pihlbald, Matthew Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Pihlbald, Matthew Ophthalmology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Pihlbald, Matthew Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7169326064

Pihlbald, Matthew Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Pihlbald, Matthew Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Pollack, Stephen B. Ophthalmology Stephen B Pollack MD 1630 Maple Rd Buffalo NY 14221 Erie 7166897330

Ratnakaram, Ramakrishna Ophthalmology Faruk M Koreishi Md Pc 3055 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7167122440

Ratnakaram, Ramakrishna Ophthalmology Faruk M Koreishi Md Pc 6637 Main St Williamsville NY 14221 Erie 7166321595

Ratnakaram, Ramakrishna Ophthalmology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Reidy, James J. Ophthalmology University Opthalmology Services Inc 462 Grider St Rm Cc133 Buffalo NY 14215 Erie 7168984652

Reidy, James J. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Reidy, James J. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Reidy, James J. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Reidy, James J. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 115 Amherst NY 14226 Erie 7168341113

Reynolds, James D. Ophthalmology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621759

Reynolds, James D. Ophthalmology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Reynolds, James D. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168341113

Reynolds, James D. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Reynolds, James D. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Reynolds, James D. Ophthalmology Mercy Hospital 565 Abbott Rd Buffalo NY 14224 Erie 7168267000

Reynolds, James D. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Rodman, David J. Ophthalmology David J Rodman Md Llc 1150 Youngs Rd Ste 202 Williamsville NY 14221 Erie 7166893987

Rodman, David J. Ophthalmology Buffalo Medical Group 1150 Young Rd Williamsville NY 14221 Erie 7168578654

Rodman, David J. Ophthalmology Buffalo Medical Group 6245 Sheridan Dr Williamsville NY 14221 Erie 7168578654

Rodman, David J. Ophthalmology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578654

Rodman, David J. Ophthalmology David J Rodman Md Llc 100 High St Buffalo NY 14203 Erie 7168541137

Sansano Jr, Michael Ophthalmology Sansano, Michael 515 Abbott Rd Ste 206 Buffalo NY 14220 Erie 7168283460

Schaefer, Daniel P. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Schaefer, Daniel P. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Schaefer, Daniel P. Ophthalmology University Opthalmology Services Inc 4590 Main St Buffalo NY 14226 Erie 7168393535

Schaefer, Daniel P. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Schaefer, Daniel P. Ophthalmology Daniel P Schaefer MD PC 4590 Main St Snyder NY 14226 Erie 7168393535

Schlisserman, Albert Ophthalmology A Schlisserman Md 3151 Southwestern Blvd Orchard Park NY 14127 Erie 7166746030

Selvadurai, Ausra D. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Selvadurai, Ausra D. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Selvadurai, Ausra D. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Selvadurai, Ausra D. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Selvadurai, Deepan Ophthalmology Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Sharma, Vishal Ophthalmology Sharma Ophthalmology, PLLC 2816 Pleasant Ave Lake View NY 14085 Erie 7166465500

Sharma, Vishal Ophthalmology Sharma Ophthalmology, PLLC 4855 Camp Rd Ste 400 Hamburg NY 14075 Erie 7166989194

Sharma, Vishal Ophthalmology Sharma Ophthalmology, PLLC 303 Sterling Dr Orchard Park NY 14127 Erie 7167120600

Shastri, Rameshchandr H. Ophthalmology Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Siedlecki, Andrew J. Ophthalmology Andrew J Siedlecki MD PC 170 Maple Rd Williamsville NY 14221 Erie 7166348500

Siedlecki, Andrew J. Ophthalmology Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

Siedlecki, Andrew J. Ophthalmology Andrew J Siedlecki MD PC 3055 Southwestern Blvd Ste 106 Orchard Park NY 14127 Erie 7166348500

Sieminski, Sandra F. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Sieminski, Sandra F. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Sieminski, Sandra F. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Page 89 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Sieminski, Sandra F. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Sirkin, Sara R. Ophthalmology Amar Atwal MD PC 2441 Sheridan Dr Tonawanda NY 14150 Erie 7168368700

Sirkin, Sara R. Ophthalmology Sara R Sirkin MD 2441 Sheridan Dr Tonawanda NY 14150 Erie 7168368700

Stathopoulos, Nicholas A. Ophthalmology Russell G Knapp Md 1890 Colvin Blvd Tonawanda NY 14150 Erie 7168375200

Sullivan, John M. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168341113

Sullivan, John M. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Todoro, Carl A. Ophthalmology Amar Atwal MD PC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166498300

Tung, Cynthia I. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7169326064

Tung, Cynthia I. Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168341113

Tung, Cynthia I. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Twist, James F. Ophthalmology Twist, James 2156 Sheridan Dr Kenmore NY 14223 Erie 7168737227

Vilardo, Michael L. Ophthalmology Michael Vilardo MD PC 4800 N French Rd East Amherst NY 14051 Erie 7166880996

Vilardo, Michael L. Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Vilardo, Michael L. Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Vilardo, Michael L. Ophthalmology Amar Atwal MD PC 4800 N French Rd East Amherst NY 14051 Erie 7166880996

Vilardo, Michael L. Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Walcott, Karen W. Ophthalmology Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

Walcott, Karen W. Ophthalmology Andrew J Siedlecki MD PC 170 Maple Rd Williamsville NY 14221 Erie 7166348500

Weitzenkorn, Dan E. Ophthalmology Amar Atwal MD PC 1900 Ridge Rd West Seneca NY 14225 Erie 7166745966

Weitzenkorn, Dan E. Ophthalmology Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Wilamowski, Henry G. Ophthalmology Wilamowski, Henry 702 Dick Rd Buffalo NY 14225 Erie 7166812020

Yoganathan, Pradeepa Ophthalmology University Opthalmology Services Inc 3580 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

Yoganathan, Pradeepa Ophthalmology University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Yoganathan, Pradeepa Ophthalmology University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Yoganathan, Pradeepa Ophthalmology University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Amabile, Kristin A. Optometry Johnson & Amabile OD, PLLC 2064 Seneca St Buffalo NY 14210 Erie 7168221515

Amabile, Kristin A. Optometry Amabile, Kristin 6224 Transit Rd Depew NY 14043 Erie 7166835566

Amabile, Kristin A. Optometry Johnson & Amabile OD, PLLC 6224 Transit Rd Depew NY 14043 Erie 7166835566

Amabile, Kristin A. Optometry Amabile, Kristin 2064 Seneca St Buffalo NY 14210 Erie 7168221515

Amabile, Kristin A. Optometry Johnson & Amabile OD, PLLC 2864 Delaware Ave Kenmore NY 14217 Erie 7168744119

Amabile, Kristin A. Optometry Amabile, Kristin 2864 Delaware Ave Kenmore NY 14217 Erie 7168744119

Amabile, Kristin A. Optometry Johnson & Amabile OD, PLLC 3290 Sheridan Dr Amherst NY 14226 Erie 7166911192

Amabile, Kristin A. Optometry Roger Amabile Dba Buffalos Best Op 2064 Seneca St Buffalo NY 14210 Erie 7168221515

Arenos, Deborah D. Optometry Edward A Legarreta MD 2720 Union Rd Cheektowaga NY 14227 Erie 7166683030

Arenos, Deborah D. Optometry Edward A Legarreta MD 1301 N Forest Rd Ste 7 Williamsville NY 14221 Erie 7166332203

Atkinson, Arthur M. Optometry Williamsville Optical 5467 Main St Williamsville NY 14221 Erie 7166327944

Atkinson, Arthur M. Optometry Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

Balsom, Herschel J. Optometry Wagner Optical Inc 945 Broadway St Buffalo NY 14212 Erie 7168456080

Barbarossa, Francesco J. Optometry Ashvani Gulati 3750 Delaware Ave Kenmore NY 14217 Erie 7168742455

Bartels, David P. Optometry Clarence Eye Care 8560 Main St Buffalo NY 14221 Erie 7166682020

Bartels, David P. Optometry David P Bartels OD 2126 Niagara Falls Blvd Tonawanda NY 14150 Erie 7166934606

Bartels, David P. Optometry Clarence Eye Care 2126 Niagara Falls Blvd Tonawanda NY 14150 Erie 7166934606

Bartels, David P. Optometry David P Bartels OD 8560 MAIN ST Buffalo NY 14221 Erie 7166682020

Bartels, David P. Optometry Battin Opticians LLC 1161 Abbott Rd Buffalo NY 14220 Erie 7168242631

Battin Jr, Joseph W. Optometry Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

Battin Jr, Joseph W. Optometry Dr Joseph W Battin Jr 4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Battin Jr, Joseph W. Optometry Battin Opticians LLC 1161 Abbott Rd Buffalo NY 14220 Erie 7168242631

Battin Jr, Joseph W. Optometry Battin Opticians LLC 6175 Park Ave Hamburg NY 14075 Erie 7166463937

Battin Jr, Joseph W. Optometry Andrew J Siedlecki MD PC 170 Maple Road Williamsville NY 14221 Erie 7166348500

Beiter, James G. Optometry South Park Optical 3861 S Park Ave Blasdell NY 14219 Erie 7168236093

Bench, Steven I. Optometry 20/20 Westside Eye Care 324 W Ferry St Buffalo NY 14213 Erie 7168834747

Beyer, Jillian Optometry 51 Buffalo St Hamburg NY 14075 Erie 7166491035

Beyer, Jillian Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 154 French Rd Cheektowaga NY 14227 Erie 7166680711

Beyer, Jillian Optometry 4050 Clinton St Clabeaux Optical West Seneca NY 14224 Erie 7166756100

Beyer, Jillian Optometry South Park Optical 3861 S Park Ave Buffalo NY 14219 Erie 7168236093

Beyer, Jillian Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 2735 S Park Ave Lackawanna NY 14218 Erie 7168269230

Beyer, Jillian Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 3035 Genesee St Cheektowaga NY 14225 Erie 7168963351

Beyer, Jillian Optometry Baker Optical Company Inc 1028 B Union Rd West Seneca NY 14224 Erie 7166746060

Bielinski, John Optometry Bielinski, John 999 Broadway Buffalo NY 14212 Erie 7168929373

Biondolillo, Joseph C. Optometry Biondolillo Eye Care LLC 206 Lake St Hamburg NY 14075 Erie 7166491010

Blackley III, John C. Optometry Eye Care Professionals of WNY LLP 750 Dick Rd Cheektowaga NY 14225 Erie 7166841622

Blackley III, John C. Optometry Eye Care Professionals of WNY LLP 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Blackley III, John C. Optometry Eye Care Professionals of WNY LLP 4703 Transit Rd Depew NY 14043 Erie 7166562011

Boryszak, Ethan J. Optometry Seneca Optical Inc 1881 Ridge Rd Ste 200 West Seneca NY 14224 Erie 7166779800

Boryszak, Ethan J. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 2735 South Park Ave Lackawanna NY 14218 Erie 7168269230

Boryszak, Ethan J. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 154 French Rd Cheektowaga NY 14227 Erie 7166680711

Page 90 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Boryszak, Ethan J. Optometry Main Place Optical Inc Dba Sterling Optical 350 Main St Buffalo NY 14202 Erie 7168542980

Boryszak, Ethan J. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 3035 Genesee St Cheektowaga NY 14225 Erie 7168963351

Boryszak, Ethan J. Optometry Licata Optical Co Inc 8070 Transit Rd Williamsville NY 14221 Erie 7166313860

Boryszak, Eugene J. Optometry Main Place Optical Inc Dba Sterling Optical 350 Main St Main Place Mall Buffalo NY 14202 Erie 7168527571

Boryszak, Eugene J. Optometry Broadway Opticians 999 Broadway Buffalo NY 14212 Erie 7168929373

Brzezicki Jr, John M. Optometry DSS Ophthalmic Dispensing PC 875 Brighton Rd Tonawanda NY 14150 Erie 7168320296

Brzezicki Jr, John M. Optometry D C Family Eye Care 6421 W Quaker St Orchard Park NY 14127 Erie 7166624525

Bui, Gigi Optometry Council Eye Care Inc 4243 Transit Rd Williamsville NY 14221 Erie 7166332440

Bui, Gigi Optometry Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Bui, Gigi Optometry EyeMac Corp 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168241320

Bui, Gigi Optometry Fichte Eye Associates Pc 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Bui, Gigi Optometry Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Bui, Gigi Optometry Fichte Eye Associates Pc 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Bui, Gigi Optometry Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Bui, Gigi Optometry Fichte Eye Associates Pc 2825 Niagara Falls Blvd West Amherst NY 14228 Erie 7165642020

Bulas, Annette M. Optometry A Schlisserman Md 3151 Southwestern Blvd Orchard Park NY 14127 Erie 7166746030

Burstein, David A. Optometry Kenmore Eye Care Inc 924 Kenmore Ave Buffalo NY 14216 Erie 7168762020

Burstein, David A. Optometry Kenmore Eye Care Inc 224 Plaza Dr Ste B Williamsville NY 14221 Erie 7166888127

Calhoun, Jeffrey J. Optometry Leonard Gurevich Md Pc Dba Western New 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Calhoun, Jeffrey J. Optometry Calhoun Eyecare And Optometry Pc 6622 Main St Ste7 Williamsville NY 14221 Erie 7166319970

Cassata, Adrienne M. Optometry Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Cassata, Adrienne M. Optometry EyeMac Corp 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168241320

Cassata, Adrienne M. Optometry Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Cassata, Adrienne M. Optometry Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Chen Rawson, Ing Chyong Optometry Ing-Chyong Chen-Rawson OD 1865 Maple Rd Williamsville NY 14221 Erie 7166324877

Chen Rawson, Ing Chyong Optometry Ing-Chyong Chen-Rawson OD 2864 Delaware Ave Kenmore NY 14217 Erie 7168744119

Chen Rawson, Ing Chyong Optometry Empire Vision Center Inc Mckinley Milestrip Plz 3540 Mckinley Pkwy Hamburg NY 14219 Erie 7168261673

Chen Rawson, Ing Chyong Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Chen Rawson, Ing Chyong Optometry Ing-Chyong Chen-Rawson OD 1261 Niagara Falls Blvd Amherst NY 14226 Erie 7168382020

Cieri, Michael J. Optometry Thomas Turtle Opticians 9346 Transit Rd East Amherst NY 14051 Erie 7166883944

Clancy, Shawn Optometry Aurora Optometric Group 980 W Maple Rd Elma NY 14059 Erie 7166520870

Cornell McCoy, Diane C. Optometry Allen Golibersuch DBA Alden Optical Studio 12444 Broadway Alden NY 14004 Erie 7169378888

Couzins, Christopher S. Optometry Couzins, Christopher S. 23 N Main St PO Box 578 Holland NY 14080 Erie 7165372222

Cress, Diane L. Optometry Thomas M Kaminska OD 3356 Genesee St Cheektowaga NY 14225 Erie 7166312020

Cress, Diane L. Optometry Cress, Diane 1006 Elmwood Ave Buffalo NY 14222 Erie 7168839855

Cress, Diane L. Optometry Leonard Gurevich Md Pc Dba Western New 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Cress, Diane L. Optometry Cress, Diane 742 Tonawanda St Buffalo NY 14207 Erie 7163620800

Cress, Diane L. Optometry Cress, Diane 1261 Niagara Falls Blvd Amherst NY 14226 Erie 7168382020

Crinzi, Alexander R. Optometry Gambacorta, Joseph 2290 Main St Buffalo NY 14214 Erie 7168351105

Crinzi, Alexander R. Optometry Eye Care Professionals of WNY LLP 4703 Transit Rd Depew NY 14043 Erie 7166562011

Crinzi, Alexander R. Optometry Creighton Optical 13375 Broadway Alden NY 14004 Erie 7169377373

Crinzi, Alexander R. Optometry University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

Crinzi, Alexander R. Optometry Eye Care Professionals of WNY LLP 2290 Main St Buffalo NY 14214 Erie 7168351105

Crinzi, Alexander R. Optometry University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

Crinzi, Alexander R. Optometry Eye Care Professionals of WNY LLP 750 Dick Rd Cheektowaga NY 14225 Erie 7166841622

Crinzi, Alexander R. Optometry University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

Crinzi, Alexander R. Optometry Eye Care Professionals of WNY LLP 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Czapla, Ernest E. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Czapla, Ernest E. Optometry Empire Vision Center Inc 3540 Mckinley Pkwy Mckinley Milestrip Plz Buffalo NY 14219 Erie 7168261673

Daly, Shannon L. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 2735 South Park Ave Lackawanna NY 14218 Erie 7168269230

Daly, Shannon L. Optometry Wagner Optical Inc 945 Broadway Buffalo NY 14212 Erie 7168456080

Daly, Shannon L. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 154 French Rd Cheektowaga NY 14227 Erie 7166680711

Daly, Shannon L. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 3035 Genesee St Cheektowaga NY 14225 Erie 7168963351

Daniels, Errol S. Optometry Ophthalmology Associates Of Wny 6333 Main St Williamsville NY 14221 Erie 7166323545

Del Prince, Katie L. Optometry Aurora Optometric Group 980 W Maple Ct Elma NY 14059 Erie 7166520870

Del Prince, Keith F. Optometry Aurora Optometric Group 980 W Maple Rd Elma NY 14059 Erie 7166520870

DeMario, J Todd Optometry Council Opticians of Hamburg 5999 S Park Ave Hamburg NY 14075 Erie 7166485761

DeMario, J Todd Optometry Council Opticians of East Aurora Inc 323 Main St East Aurora NY 14052 Erie 7166553225

Desai, Kalindi M. Optometry Empire Vision Center Inc 3540 McKinley Pkwy Buffalo NY 14219 Erie 7168261673

Desai, Kalindi M. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Desai, Kalindi M. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Buffalo NY 14225 Erie 7166836582

Desai, Kalindi M. Optometry Andrew J Siedlecki MD PC 170 Maple Rd Williamsville NY 14221 Erie 7166348500

Desai, Kalindi M. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Dougherty, Jacqueline M. Optometry Amar Atwal MD PC 227 Highland Pkwy Kenmore NY 14223 Erie 7168968831

Dougherty, Jacqueline M. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Dougherty, Jacqueline M. Optometry D C Family Eye Care 6421 W Quaker St Orchard Park NY 14127 Erie 7166624525

Page 91 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Dougherty, Jacqueline M. Optometry Amar Atwal MD PC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166498300

Dougherty, Jacqueline M. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Dougherty, Jacqueline M. Optometry Empire Vision Center Inc 3540 McKinley Parkway Blasdell NY 14219 Erie 7168261673

Dougherty, Jacqueline M. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Downey, Anne M. Optometry Eye Care Professionals of WNY LLP 4703 Transit Rd Depew NY 14043 Erie 7166562011

Downey, Anne M. Optometry Eye Care Professionals of WNY LLP 2290 Main St Buffalo NY 14214 Erie 7168351105

Downey, Anne M. Optometry Eye Care Professionals of WNY LLP 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Downey, Anne M. Optometry Eye Care Professionals of WNY LLP 750 Dick Rd Cheektowaga NY 14215 Erie 7166841622

Freitag, Peter J. Optometry Amar Atwal MD PC 1900 Ridge Rd West Seneca NY 14224 Erie 7166745966

Freitag, Peter J. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Freitag, Peter J. Optometry Pearle Vision (Jag Eyes) 8005 Main St Williamsville NY 14221 Erie 7166349129

Gambacorta, Joseph P. Optometry Eye Care Professionals of WNY LLP 2290 Main St Buffalo NY 14214 Erie 7168351105

Gambacorta, Joseph P. Optometry Eye Care Professionals of WNY LLP 750 Dick Rd Cheektowaga NY 14215 Erie 7166841622

Gambacorta, Joseph P. Optometry Eye Care Professionals of WNY LLP 4703 Transit Rd Depew NY 14043 Erie 7166562011

Gambacorta, Joseph P. Optometry Eye Care Professionals of WNY LLP 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Genovese, Lisa Optometry Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Genovese, Lisa Optometry Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Genovese, Lisa Optometry EyeMac Corp 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168241320

Genovese, Lisa Optometry Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Genovese, Lisa Optometry Fichte Eye Associates Pc 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Gibbons, Katherine L. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Gibbons, Katherine L. Optometry Pearle Vision (Jag Eyes) 8005 Main St Williamsville NY 14221 Erie 7166349129

Glose, Jennifer M. Optometry EyeMac Corp 3701 S McKinley Pkwy Buffalo NY 14219 Erie 7168241320

Glose, Jennifer M. Optometry Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Glose, Jennifer M. Optometry Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Glose, Jennifer M. Optometry Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Hammersmith, John T. Optometry Eye Care & Vision Associates One Hopkins Rd Williamsville NY 14221 Erie 7166318888

Hammersmith, John T. Optometry Eye Care & Vision Associates 932 Elmwood Ave Buffalo NY 14222 Erie 7168840880

Hammersmith, John T. Optometry Eye Care & Vision Associates 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7166485329

Honeyman, Michael F. Optometry Am Clar Optical Inc DBA Sterling Optical 4545 Transit Rd Williamsville NY 14221 Erie 7166325497

Honeyman, Michael F. Optometry Seneca Optical Inc 1881 Ridge Rd Ste 200 West Seneca NY 14224 Erie 7166779800

Honeyman, Michael F. Optometry Am-Ton Optical Inc 1202 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168337766

Hornberger Jr, Charles J. Optometry Schutz Optical Co Inc 8425 Boston State Rd Boston NY 14025 Erie 7166415585

Hornberger Jr, Charles J. Optometry Schutz Optical Co Inc 3192 Walden Ave Depew NY 14043 Erie 7166843124

Hornberger Jr, Robert H. Optometry Hornberger Jr, Robert H. 2507 Harlem Rd Cheektowaga NY 14225 Erie 7168930633

Hornberger Jr, Robert H. Optometry Hornberger, Robert 3861 S Park Ave Buffalo NY 14219 Erie 7168236093

Hornberger Jr, Robert H. Optometry Hornberger & Lee LLC 902 Main St Buffalo NY 14202 Erie 7168839550

Hornberger Jr, Robert H. Optometry Town Park Optical 2507 Harlem Rd Cheektowaga NY 14225 Erie 7168930633

Hornberger Jr, Robert H. Optometry South Park Optical 3861 S Park Ave Blasdell NY 14219 Erie 7168236093

Hornberger Jr, Robert H. Optometry Hornberger Jr, Robert H. 902 Main St Buffalo NY 14202 Erie 7168839550

Hornberger Sr, Charles J. Optometry Schutz Optical Co Inc 8425 Boston State Rd Boston NY 14025 Erie 7169415585

Hornberger Sr, Charles J. Optometry Schutz Optical Co Inc 3192 Walden Ave Depew NY 14043 Erie 7166843124

Howard, Michael G. Optometry Amar Atwal MD PC 4800 N French Rd East Amherst NY 14051 Erie 7166880996

Howard, Michael G. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Joba, Robert J. Optometry R J Joba OD PC 6929 Erie Rd Derby NY 14047 Erie 7169472462

Joba, Robert J. Optometry Amar Atwal MD PC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166498300

Joba, Robert J. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Johnson, Timothy Optometry Johnson & Amabile OD, PLLC 2864 Delaware Ave Kenmore NY 14217 Erie 7168744119

Johnson, Timothy Optometry Johnson & Amabile OD, PLLC 2064 Seneca St Buffalo NY 14210 Erie 7168221515

Johnson, Timothy Optometry Johnson & Amabile OD, PLLC 6224 Transit Rd Depew NY 14043 Erie 7166835566

Johnson, Timothy Optometry Johnson & Amabile OD, PLLC 3290 Sheridan Dr Amherst NY 14226 Erie 7166911192

Kaminska, Thomas M. Optometry Thomas M Kaminska OD 3356 Genesee St Cheektowaga NY 14225 Erie 7166312020

Kasprzak, Steve Optometry Luxottica Retail of North America 4224 Maple Rd Amherst NY 14226 Erie 7168330803

Kasprzak, Steve Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Buffalo NY 14225 Erie 7166836582

Kasprzak, Steve Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Kasprzak, Steve Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Kasprzak, Steve Optometry Empire Vision Center Inc 3540 McKinley Pkwy Hamburg NY 14219 Erie 7168261673

Khan, Rima M. Optometry Rima Khan OD PLLC 4545 Transit Rd Williamsville NY 14221 Erie 7166342209

Khan, Rima M. Optometry Thomas M Kaminska OD 3356 Genesee St Cheektowaga NY 14225 Erie 7166312020

Kim, Roy H. Optometry Empire Vision Center Inc 1308 Niagra Falls Blvd Tonawanda NY 14150 Erie 7168318050

Kim, Roy H. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Buffalo NY 14225 Erie 7166836582

Kim, Roy H. Optometry Empire Vision Center Inc 3540 McKinley Pkwy Buffalo NY 14219 Erie 7168261673

Kirchberger Howard, Julie M. Optometry Thomas Turtle Opticians 9346 Transit Rd East Amherst NY 14051 Erie 7166883944

Kokotow, Natalie L. Optometry DSS Ophthalmic Dispensing PC 875 Brighton Rd Tonawanda NY 14150 Erie 7168320296

Kokotow, Natalie L. Optometry NK Optical LLC 4245 Union Rd Ste 105 Cheektowaga NY 14225 Erie 7166342678

Kokotow, Natalie L. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Page 92 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kokotow, Natalie L. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Kokotow, Natalie L. Optometry Empire Vision Center Inc 3540 Mckinley Pkwy Hamburg NY 14219 Erie 7168261673

Kokotow, Natalie L. Optometry Williamsville Optical 5467 Main St Williamsville NY 14221 Erie 7166327944

Kokotow, Natalie L. Optometry Kokotow, Natalie 3945 Main St Amherst NY 14226 Erie 7168323452

Kolo, Marcelle M. Optometry Luxottica Retail of North America 4224 Maple Rd Amherst NY 14226 Erie 7168331046

Kolo, Marcelle M. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Kolo, Marcelle M. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Komm, Kevin D. Optometry Komm, Kevin 2342 Niagara Falls Blvd Tonawanda NY 14150 Erie 7166944388

Komm, Kevin D. Optometry Komm, Kevin 2342 Niagara Falls Blvd Tonawanda NY 14150 Erie 7166944388

Kraden, Arnold Optometry 20/20 Westside Eye Care 324 W Ferry St Buffalo NY 14213 Erie 7168834747

Krafchak, David A. Optometry EyeMac Corp 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168241320

Krafchak, David A. Optometry David A Krafchak 3701 S Mckinley Pkwy Blasdell NY 14219 Erie 7168241320

Krieger, Michael J. Optometry Schutz Optical Co Inc 3192 Walden Ave Depew NY 14043 Erie 7166843124

Krieger, Michael J. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Krieger, Michael J. Optometry 3876 S Park Ave Buffalo NY 14219 Erie 7168222264

Krygier Murphy, Jocelyn Optometry Eye Health Associates of WNY PC dba Anthone Eye Center 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Krygier Murphy, Jocelyn Optometry Eye Health Associates of WNY PC dba Anthone Eye Center 2211 Sheridan Dr Tonawanda NY 14223 Erie 7166346100

Kuczmarski, Joseph F. Optometry Troidl Optical Inc 665 Cleveland Dr Cheektowaga NY 14225 Erie 7168364949

Kuczmarski, Joseph F. Optometry Kuczmarski, Joseph F. 13375 Broadway Ave Alden NY 14004 Erie 7169376078

Kuczmarski, Joseph F. Optometry Creighton Optical 13375 Broadway Alden NY 14004 Erie 7169377373

LaDota, Anthony P. Optometry EyeMac Corp 3701 S McKinley Pkwy Buffalo NY 14219 Erie 7168241320

LaDota, Anthony P. Optometry LaDota Optometry PC 448 Delaware St Tonawanda NY 14150 Erie 7166952024

LaDota, Anthony P. Optometry Steven Awner 3980 Sheridan Dr Ste 402 Amherst NY 14226 Erie 7162044516

Leber, Jenna N. Optometry Amar Atwal MD PC 1900 Ridge Rd Ste B West Seneca NY 14224 Erie 7166745968

Leber, Jenna N. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Leberer, Ian C. Optometry Ian C. Leberer 2101 Elmwood Ave Buffalo NY 14207 Erie 7168742020

Leberer, Ian C. Optometry Ian C. Leberer 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168215712

Leberer, Ian C. Optometry Ian C. Leberer 3945 Main St Amherst NY 14226 Erie 7168323452

Leberer, Ian C. Optometry EyeMac Corp 3701 S McKinley Pkwy Buffalo NY 14219 Erie 7168241320

Leonard, Patti L. Optometry Eye Care Professionals of WNY LLP 4703 Transit Rd Depew NY 14043 Erie 7166562011

Leonard, Patti L. Optometry Eye Care Professionals of WNY LLP 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Leonard, Patti L. Optometry Eye Care Professionals of WNY LLP 750 Dick Rd Cheektowaga NY 14215 Erie 7166841622

Long, Leslie A. Optometry Bell Optical 3427 Transit Rd Depew NY 14043 Erie 7166686401

Long, Leslie A. Optometry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Loughrey, Mary Ellen Optometry Niswander Eye Center Philip Niswander Md 40 N Union Rd Williamsville NY 14221 Erie 7166344441

Maclaughlin, Jason K. Optometry EyeMac Corp 3945 Main St Amherst NY 14226 Erie 7168323452

Maclaughlin, Jason K. Optometry EyeMac Corp 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168241320

Maclaughlin, Jason K. Optometry Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Martin, Bernard F. Optometry Martin, Bernard 2205 Kensington Ave Snyder NY 14226 Erie 7168392236

Martin, Bernard F. Optometry Wagner Optical Inc 945 Broadway Buffalo NY 14212 Erie 7168456080

Matuszak, Brian A. Optometry Eye Health Associates of WNY PC dba Anthone Eye Center 2211 Sheridan Dr Tonawanda NY 14223 Erie 7166346100

Matuszak, Brian A. Optometry Eye Health Associates of WNY PC dba Anthone Eye Center 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Matuszak, Brunilde Optometry DSS Ophthalmic Dispensing PC 875 Brighton Rd Tonawanda NY 14150 Erie 7168320296

Matuszak, Brunilde Optometry Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787569

Matveev, Dimitri A. Optometry Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

Matveev, Dimitri A. Optometry Andrew J Siedlecki MD PC 170 Maple Road Buffalo NY 14221 Erie 7166348500

Matveev, Dimitri A. Optometry Williamsville Optical 5467 Main St Williamsville NY 14221 Erie 7166327944

May, Lindsay A. Optometry Andrew J Siedlecki MD PC 170 Maple Rd Buffalo NY 14221 Erie 7166348500

May, Lindsay A. Optometry Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

May, Lindsay A. Optometry Battin Opticians LLC 6175 S Park Ave Hamburg NY 14075 Erie 7166463937

May, Lindsay A. Optometry Battin Opticians LLC 1161 Abbott Rd Buffalo NY 14220 Erie 7168242631

McDonel, James A. Optometry South Park Optical 3861 S Park Ave Blasdell NY 14219 Erie 7168236093

McDonel, James A. Optometry University Opthalmology Services Inc 3850 Sheridan Dr Ste 150 Amherst NY 14226 Erie 7168817900

McDonel, James A. Optometry University Opthalmology Services Inc 1176 Main St Buffalo NY 14209 Erie 7168817900

McDonel, James A. Optometry University Opthalmology Services Inc 27 Franklin St Springville NY 14141 Erie 7165925006

McDonel, James A. Optometry University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7168817900

McDonel, James A. Optometry NK Optical LLC 4245 Union Rd Ste 105 Cheektowaga NY 14225 Erie 7166342678

McDonough, Eugene J. Optometry Eye Care & Vision Associates 932 Elmwood Ave Buffalo NY 14222 Erie 7168840880

McDonough, Eugene J. Optometry Eye Care & Vision Associates 3712 Southwestern Ave Orchard Park NY 14127 Erie 7166485329

Mendola, Calogera L. Optometry Amar Atwal MD PC 3095 Harlem Rd Buffalo NY 14225 Erie 7168968831

Metsa, Melanie Optometry Amar Atwal MD PC 227 Highland Pkwy Kenmore NY 14223 Erie 7168734545

Miller, Aimee J. Optometry 4545 Transit Rd Williamsville NY 14221 Erie 7166314284

Miller, Aimee J. Optometry South Park Optical 3861 S Park Ave Buffalo NY 14219 Erie 7168236093

Miller, Patricia M. Optometry Aurora Optometric Group 980 W Maple Rd Elma NY 14059 Erie 7166520870

Mohan, William J. Optometry SVS Vision Inc 1551 Niagara Falls Blvd Amherst NY 14228 Erie 7168326172

Mohan, William J. Optometry SVS Vision Inc 4408 Milestrip Rd Blasdell NY 14219 Erie 7168219199

Page 93 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Mohan, William J. Optometry Akron Village Optical 10 Main St Akron NY 14001 Erie 7165422110

Mohsini, Wasim Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Murphy, Michael S. Optometry Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Murphy, Michael S. Optometry Clarence Eye Care 8560 Main St Buffalo NY 14221 Erie 7166682020

Murphy, Michael S. Optometry Fichte Eye Surgery 2825 Niagara Falls Blvd Ste 130 Amherst NY 14228 Erie 7165642020

Murphy, Michael S. Optometry Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Myers, Matthew R. Optometry Council Eye Care Inc 4243 Transit Rd Williamsville NY 14221 Erie 7166332440

Needham, Dennis J. Optometry Thomas Turtle Opticians 12469 Olean Rd Chaffee NY 14030 Erie 7164967454

Needham, Dennis J. Optometry Council Opticians of Lockport 323 Main St East Aurora NY 14052 Erie 7164338235

Needham, Dennis J. Optometry Thomas Turtle Opticians 5430 Broadway Lancaster NY 14086 Erie 7166854050

Needham, Dennis J. Optometry Best Vision Inc 12469 Olean Rd Chaffee NY 14030 Erie 7164967454

Noworyta Jr, Joseph L. Optometry Joseph Noworyta 3876 S Park Ave Blasdell NY 14219 Erie 7168222264

Noworyta Jr, Joseph L. Optometry Empire Vision Center Inc 3859 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Noworyta Jr, Joseph L. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

O Connor, Richard D. Optometry Aurora Optometric Group 980 W Maple Rd Elma NY 14059 Erie 7166520870

O Connor, Thomas J. Optometry Edward A Legarreta MD 1301 N Forest Rd Williamsville NY 14221 Erie 7166332203

O Connor, Thomas J. Optometry Edward A Legarreta MD 2720 Union Rd Cheektowaga NY 14227 Erie 7166683030

Orzech, Patricia L. Optometry Empire Vision Center Inc Mckinley Milestrip Plz 3540 Mckinley Pkwy Hamburg NY 14219 Erie 7168261673

Orzech, Patricia L. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Orzech, Patricia L. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Patel-Chille, Nehal P. Optometry University Opthalmology Services Inc 301 Sterling Dr Orchard Park NY 14127 Erie 7166676500

Patel-Chille, Nehal P. Optometry Leonard Gurevich Md Pc Dba Western New 301 Sterling Dr Orchard Park NY 14127 Erie 7166776500

Patel-Chille, Nehal P. Optometry Leonard Gurevich Md Pc Dba Western New 27 Franklin St Springville NY 14141 Erie 7165925006

Paterno, Michael R. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Pietrasik, Rebecca L. Optometry Sharma Ophthalmology, PLLC 2816 Pleasant Ave Lake View NY 14085 Erie 7166465500

Pronti, Paul M. Optometry Buffalo Optical Company Inc 280 Delaware Ave Buffalo NY 14202 Erie 7168541620

Pronti, Paul M. Optometry Buffalo Optical Company Inc 4080 Seneca St West Seneca NY 14224 Erie 7166744110

Pronti, Paul M. Optometry Buffalo Optical Company Inc 5350 Main St Williamsville NY 14221 Erie 7166313820

Pronti, Paul M. Optometry Buffalo Optical Company Inc 2832 Delaware Ave Kenmore NY 14217 Erie 7168757779

Riedel, William M. Optometry Riedel, William M. 266 Grover Cleveland Hwy Eggertsville NY 14226 Erie 7168347647

Rodman, Mark E. Optometry Rodman, Mark 1261 Niagara Falls Blvd Amherst NY 14226 Erie 7168382020

Rodman, Mark E. Optometry Licata Optical Co Inc 8070 Transit Rd Williamsville NY 14221 Erie 7166313860

Rodman, Mark E. Optometry Mark E. Rodman 3945 Main St Amherst NY 14226 Erie 7168323452

Rogenthien, Richard E. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Rogenthien, Richard E. Optometry Empire Vision Center Inc Mckinley Milestrip Plz 3540 Mckinley Pkwy Hamburg NY 14219 Erie 7168261673

Rogenthien, Richard E. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Rosenswie, Shannon L. Optometry Council Opticians 25 E Main St Springville NY 14141 Erie 7165923322

Rosenswie, Shannon L. Optometry Springville Eye Care LLC 25 E Main St Springville NY 14141 Erie 7165923322

Rundquist, John D. Optometry Rundquist, John 4511 Main St Amherst NY 14226 Erie 7168392218

Rundquist, John D. Optometry NK Optical LLC 4245 Union Rd Ste 105 Cheektowaga NY 14225 Erie 7166342678

Rundquist, John D. Optometry Battin Opticians LLC 1161 Abbott Rd Buffalo NY 14220 Erie 7168242631

Rundquist, John D. Optometry Rundquist, John 3070 Transit Rd West Seneca NY 14224 Erie 7166681166

San George II, Charles M. Optometry Elegance Optique Ii Inc 1754 Sheridan Dr Buffalo NY 14223 Erie 7168744600

San George II, Charles M. Optometry O.D. Optometric PC 5360 Southwestern Blvd Hamburg NY 14075 Erie 7166460564

Sanford, Amanda M. Optometry Baker Optical Company Inc 1028B Union Rd Southgate Plz West Seneca NY 14224 Erie 7166746060

Sarikey, Philip A. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Sarikey, Philip A. Optometry Sarikey, Philip 1900 Ridge Rd Ste 8b Buffalo NY 14224 Erie 7166741558

Scaduto, Samuel E. Optometry Council Opticians 3768 Seneca St West Seneca NY 14224 Erie 7166748300

Schmitt, Kurt M. Optometry Empire Vision Center Inc 3540 Mckinley Parkway Hamburg NY 14219 Erie 7168261673

Schmitt, Kurt M. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Schmitt, Kurt M. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Schmitt, Kurt M. Optometry Tomasik Optical LLC 1258 Electric Ave Lackawanna NY 14218 Erie 7168257434

Schmitt, Kurt M. Optometry Allen Golibersuch DBA Alden Optical Studio 12444 Broadway Alden NY 14004 Erie 7169378888

Schwach, Timothy J. Optometry Andrew J Siedlecki MD PC 1637 Hertel Ave Buffalo NY 14216 Erie 7166348500

Schwach, Timothy J. Optometry Best Vision Inc 12469 Olean Rd Ste 1 Chaffee NY 14030 Erie 7164967454

Schwach, Timothy J. Optometry Schwach, Timothy 4003 Harlem Rd Snyder NY 14226 Erie 7168391110

Schwach, Timothy J. Optometry Andrew J Siedlecki MD PC 170 Maple Rd Williamsville NY 14221 Erie 7166348500

Schwartz, Doris M. Optometry D C Family Eye Care 6421 W Quaker St Orchard Park NY 14127 Erie 7166624525

Schwartz, Doris M. Optometry Doris M Schwartz 742 Tonawanda St Buffalo NY 14207 Erie 7163620800

Schwartz, Doris M. Optometry Thomas M Kaminska OD 3356 Genesee St Cheektowaga NY 14225 Erie 7166312020

Schwartz, Doris M. Optometry Doris M Schwartz 1006 Elmwood Ave Buffalo NY 14222 Erie 7168839855

Schwartz, Richard J. Optometry Richard J. Swchartz 1303 Niagara Falls Blvd Amherst NY 14226 Erie 7168331166

Schwartz, Richard J. Optometry Richard J. Swchartz 3 Walden Galleria Dr Cheektowaga NY 14225 Erie 7166815329

Schwartz, Richard J. Optometry Brzezicki Jr, John M. 6421 W Quaker St Orchard Park NY 14127 Erie 7166624525

Schwartz, Richard J. Optometry Richard J. Swchartz 875 Brighton Rd Tonawanda NY 14150 Erie 7168320296

Segerson, Sandra L. Optometry Kenmore Eye Care Inc 224 Plaza Dr Ste B Williamsville NY 14221 Erie 7166888127

Page 94 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Segerson, Sandra L. Optometry Kenmore Eye Care Inc 224 Plaza Dr Ste B Buffalo NY 14221 Erie 7166888127

Segerson, Sandra L. Optometry Kenmore Eye Care Inc 924 Kenmore Ave Buffalo NY 14216 Erie 7168762020

Sendker, Matthew E. Optometry Eye Care Professionals of WNY LLP 2290 Main St Buffalo NY 14214 Erie 7168351105

Sendker, Matthew E. Optometry Eye Care Professionals of WNY LLP 750 Dick Rd Cheektowaga NY 14215 Erie 7166841622

Sendker, Matthew E. Optometry Eye Care Professionals of WNY LLP 4703 Transit Rd Depew NY 14043 Erie 7166562011

Sendker, Matthew E. Optometry Sendker, Matthew 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Sendker, Matthew E. Optometry Creighton Optical 13375 Broadway Alden NY 14004 Erie 7169377373

Sendker, Matthew E. Optometry Eye Care Professionals of WNY LLP 3364 Sheridan Dr Amherst NY 14226 Erie 7168332020

Shams, Nazanin Optometry Stanton Optical 2965 Sheridan Dr Tonawanda NY 14150 Erie 7168313711

Shenkle, Linda S. Optometry Fichte Eye Surgery 2211 Sheridan Dr Buffalo NY 14223 Erie 7168746010

Shenkle, Linda S. Optometry Fichte Eye Surgery 170 Maple Rd Buffalo NY 14221 Erie 7166322020

Sickler, James P. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 154 French Rd Cheektowaga NY 14227 Erie 7166680711

Sickler, James P. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 2735 S Park Ave Lackawanna NY 14218 Erie 7168269230

Sickler, James P. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 3035 Genesee St Buffalo NY 14225 Erie 7168963351

Simmons, James A. Optometry Elizabeth Pierce Olmsted MD Center for the Visually Imp 1170 Main St Buffalo NY 14209 Erie 7168821025

Simmons, James A. Optometry Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168821025

Simmons, James A. Optometry Elizabeth Pierce Olmsted MD Center for the Visually Imp 1491 Sheridan Dr Ste 600 Buffalo NY 14216 Erie 7168821025

Smith, Donald S. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Smith, Donald S. Optometry Pearle Vision (Jag Eyes) 8005 Main St Williamsville NY 14221 Erie 7166349129

Sorrentino, Mark Optometry Tomasik Optical LLC 3800 N Buffalo Rd Orchard Park NY 14127 Erie 7166670004

Sorrentino, Mark Optometry Sorrentino, Mark 403 Main St Ste 510 Buffalo NY 14203 Erie 7168527262

Styn, David T. Optometry A Schlisserman Md 3151 Southwestern Blvd Orchard Park NY 14127 Erie 7166746030

Suda, Amy E. Optometry Aurora Optometric Group 317 S Cascade Dr Springville NY 14141 Erie 7165921467

Suda, Amy E. Optometry Aurora Optometric Group 980 W Maple Rd Elma NY 14059 Erie 7166520870

Swanson, Natalie J. Optometry Biondolillo Eye Care LLC 206 Lake St Hamburg NY 14075 Erie 7166491010

Swanson, Natalie J. Optometry Eye Health Associates of WNY PC dba Anthone Eye Center 170 Maple Rd Williamsville NY 14221 Erie 7166346100

Swanson, Natalie J. Optometry Eye Health Associates of WNY PC dba Anthone Eye Center 2211 Sheridan Dr Tonawanda NY 14223 Erie 7166346100

Towles Schwen, Michael T. Optometry Edward A Legarreta MD 1301 N Forest Rd Ste 7 Buffalo NY 14221 Erie 7166332203

Towles Schwen, Michael T. Optometry Edward A Legarreta MD 8236 Transit Rd Buffalo NY 14221 Erie 7166390847

Tran, Hieu T. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Trieu, Cuong N. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 142254256 Erie 7166836582

Trzepkowski, Francis A. Optometry Council Opticians of Batavia 323 Main St East Aurora NY 14052 Erie 7166553225

Trzepkowski, Francis A. Optometry Council Opticians of Hamburg 5999 S Park Ave Hamburg NY 14075 Erie 7166485761

Trzepkowski, Francis A. Optometry Council Opticians of East Aurora Inc 323 Main St East Aurora NY 14052 Erie 7166553225

Trzepkowski, Francis A. Optometry Council Opticians of Niagara Falls Inc 609 Oakwood Ave East Aurora NY 14052 Erie 7166553225

Turtle, David T. Optometry Thomas Turtle Opticians 3718 Delaware Ave Kenmore NY 14217 Erie 7168742345

Turtle, David T. Optometry Thomas Turtle Opticians 5430 Broadway Lancaster NY 14086 Erie 7166854050

Turtle, David T. Optometry Thomas Turtle Opticians 9346 Transit Rd East Amherst NY 14051 Erie 7166883944

Vogel, Ralph R. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 154 French Rd Cheektowaga NY 14227 Erie 7166680711

Vogel, Ralph R. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 3035 Genesee St Cheektowaga NY 14225 Erie 7168963351

Vogel, Ralph R. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 2735 S Park Ave Lackawanna NY 14218 Erie 7168269230

Vogel, Ralph R. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 2735 S Park Ave Lackawanna NY 14218 Erie 7168269230

Vogel, Ralph R. Optometry Roger Amabile Dba Buffalos Best Op 6224 Transit Rd Depew NY 14043 Erie 7166835566

Vogel, Ralph R. Optometry Roger Amabile Dba Buffalos Best Op 2064 Seneca St Buffalo NY 14210 Erie 7168221515

Vogel, Ralph R. Optometry Baker Optical Company Inc Southgate Plz 1028B Union Rd West Seneca NY 14224 Erie 7166746060

Vogel, Ralph R. Optometry Roger Amabile Dba Buffalos Best Op 2864 Delaware Ave Buffalo NY 14217 Erie 7168744119

Vogel, Ralph R. Optometry Park-Sher Optical of Buffalo NY Inc dba Value Vision 154 French Rd Cheektowaga NY 14227 Erie 7166680711

Waldron, William J. Optometry WJW Optometry PC 2077 Baseline Rd Grand Island NY 14072 Erie 7167737653

Waldron, William J. Optometry EyeMac Corp 3701 S McKinley Pkwy Blasdell NY 14219 Erie 7168241320

Weiner, Kenneth A. Optometry Bell Optical 3427 Transit Rd Depew NY 14043 Erie 7166686401

Weiner, Kenneth A. Optometry Williamsville Optical 5467 Main St Williamsville NY 14221 Erie 7166327944

Weiner, Kenneth A. Optometry SVS Vision Inc 4408 Milestrip Rd Blasdell NY 14219 Erie 7168219199

Weiner, Kenneth A. Optometry SVS Vision Inc 1551 Niagara Falls Blvd Amherst NY 14228 Erie 7168326172

Wilkes, David C. Optometry Akron Optical Shop Inc 55 Main St Akron NY 14001 Erie 7165422002

Zimmerman, Jay S. Optometry Amar Atwal MD PC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168968831

Zimmerman, Jay S. Optometry Amar Atwal MD PC 227 Highland Pkwy Kenmore NY 14223 Erie 7168734545

Zimmerman, Jay S. Optometry Pearle Vision (Jag Eyes) 8005 Main St Williamsville NY 14221 Erie 7166349129

Zimmerman, Jay S. Optometry Empire Vision Center Inc 3540 McKinley Pkwy Buffalo NY 14219 Erie 7168261673

Zimmerman, Jay S. Optometry Empire Vision Center Inc 2680 Delaware Ave Ste 2C Buffalo NY 14216 Erie 7168731241

Zimmerman, Jay S. Optometry Amar Atwal MD PC 1900 Ridge Rd Ste 8b West Seneca NY 14224 Erie 7166741558

Zimmerman, Jay S. Optometry Empire Vision Center Inc 3843 Union Rd Ste 75 Cheektowaga NY 14225 Erie 7166836582

Zimmerman, Jay S. Optometry Empire Vision Center Inc 1308 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168318050

Boyd, Barry C. Oral & Maxillofacial Surg Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Boyd, Barry C. Oral & Maxillofacial Surg Ub Oral & Maxillofacial 3435 Main St 119 Squire Hall Buffalo NY 14214 Erie 7168296637

Campbell, John H. Oral & Maxillofacial Surg Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Campbell, John H. Oral & Maxillofacial Surg Ub Oral & Maxillofacial 3435 Main St 119 Squire Hall Buffalo NY 14214 Erie 7168296637

Page 95 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Casey, David M. Oral & Maxillofacial Surg Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Frawley, Thomas K. Oral & Maxillofacial Surg Frawley, Thomas 223 Main St Hamburg NY 14075 Erie 7166497718

Goodloe III, Samuel Oral & Maxillofacial Surg Western New York Dental Group Pc 2430 N Forest Rd Getzville NY 14068 Erie 7166368686

Hall, Richard E. Oral & Maxillofacial Surg Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Hall, Richard E. Oral & Maxillofacial Surg Ub Oral & Maxillofacial 3435 Main St 119 Squire Hall Buffalo NY 14214 Erie 7168296637

Halliwell-Kemp, Tara L. Oral & Maxillofacial Surg Northtowns Oral & Maxillofacial Surgery 6483 Transit Rd East Amherst NY 14051 Erie 7166315551

Halliwell-Kemp, Tara L. Oral & Maxillofacial Surg Northtowns Oral & Maxillofacial Surgery 711 Young St Tonawanda NY 14150 Erie 7166941134

Kuriakose, Moni Abraham Oral & Maxillofacial Surg Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

McLean, Terrence R. Oral & Maxillofacial Surg Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Nasca, Maureen S. Oral & Maxillofacial Surg Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Park, Etern S. Oral & Maxillofacial Surg Ub Oral & Maxillofacial 3435 Main St 119 Squire Hall Buffalo NY 14214 Erie 7168296637

Park, Etern S. Oral & Maxillofacial Surg CCS Oncology PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168109631

O Hara, Andrew L. Orthopaedic Sports Medicine Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564830

Pula, David A. Orthopaedic Sports Medicine David Pula MD PC 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7165088515

Wilkins, Ryan D. Orthopaedic Sports Medicine Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476329

Zinno, Matthew J. Orthopaedic Sports Medicine Frank J Schlehr MD PC 15 S Forest Rd Williamsville NY 14221 Erie 7166261824

Ablove, Robert H. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043201

Ablove, Robert H. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Buffalo NY 14203 Erie 7168591256

Anders, Mark J. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Anders, Mark J. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Anders, Mark J. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

Anders, Mark J. Orthopedic Surgery University Orthopaedics Services Inc 215 Kliein Rd Buffalo NY 14221 Erie 7165686100

Anders, Mark J. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Anders, Mark J. Orthopedic Surgery University Orthopaedics Services Inc 4 Centre Dr Orchard Park NY 14127 Erie 7168295648

Anders, Mark J. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 162 Farber Hall Buffalo NY 14214 Erie 7168293670

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7169470180

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7168293670

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 550 Orchard Park Rd Buffalo NY 14224 Erie 7168293670

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Bernas, Geoffrey A. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 565 Abbott Rd Buffalo NY 14220 Erie 7168293670

Bernas, Geoffrey A. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168293670

Bevilacqua, David S. Orthopedic Surgery Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Bevilacqua, David S. Orthopedic Surgery Bevilacqua, David 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7166628087

Bisson, Leslie J. Orthopedic Surgery University Orthopaedics Services Inc 215 Klein Rd Williamsville NY 14221 Erie 7168293670

Bisson, Leslie J. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043255

Blum, Craig E. Orthopedic Surgery University Orthopaedics Services Inc S 3573 Southwestern Blvd Orchard Park NY 14127 Erie 7168293670

Blum, Craig E. Orthopedic Surgery Kaleida Health 936 Delaware Ave Buffalo NY 14209 Erie 7168881300

Blum, Craig E. Orthopedic Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787563

Blum, Craig E. Orthopedic Surgery University Orthopaedics Services Inc 219 Bryant St Buffalo NY 14222 Erie 7168293670

Blum, Craig E. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Blum, Craig E. Orthopedic Surgery Blum, Craig 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7166628090

Blum, Craig E. Orthopedic Surgery University Orthopaedics Services Inc S3673 Southwestern Blvd Orchard Park NY 14127 Erie 7166628090

Bone, Lawrence B. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983414

Bone, Lawrence B. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Ste B276 Buffalo NY 14203 Erie 7168591256

Bone, Lawrence B. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Bone, Lawrence B. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168984735

Bone, Lawrence B. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Brahmabhatt, Vikram N. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Brahmabhatt, Vikram N. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7162042557

Buran, Joseph E. Orthopedic Surgery Orthopedic Surgery PC 2733 Wehrle Dr Ste 400 Williamsville NY 14221 Erie 7166398358

Callahan Jr, John J. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Callahan Jr, John J. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Callahan Jr, John J. Orthopedic Surgery Excelsior Orthopaedics Llp 240 Red Tail Stes 1 and 2 Orchard Park NY 14127 Erie 7162509999

Cardamone, Joseph G. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Chertack, Craig S. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Chertack, Craig S. Orthopedic Surgery Northtowns Orthopedics Pc 1000 Youngs Rd Ste 201 Buffalo NY 14221 Erie 7166897731

Chertack, Craig S. Orthopedic Surgery Northtowns Orthopedics Pc 4575 Main St Buffalo NY 14226 Erie 7166361470

Clark, Lindsey D. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Clark, Lindsey D. Orthopedic Surgery University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 Orchard Park NY 14127 Erie 7169065908

Clark, Lindsey D. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Clark, Lindsey D. Orthopedic Surgery University Orthopaedics Services Inc 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Daye, Lisa A. Orthopedic Surgery Excelsior Orthopaedics Llp 240 Red Tail Ste 1 and 2 Orchard Park NY 14127 Erie 7162509999

Daye, Lisa A. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Buffalo NY 14226 Erie 7162509999

Page 96 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

De Marchi, John J. Orthopedic Surgery De Marchi, John 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7166626832

Doak, Jeremy P. Orthopedic Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787563

Doak, Jeremy P. Orthopedic Surgery University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Doak, Jeremy P. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7168292070

Douglas, Donald P. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Douglas, Donald P. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Buffalo NY 14226 Erie 7166361470

Duquin, Thomas R. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

Duquin, Thomas R. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Duquin, Thomas R. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Falcone, Joseph P. Orthopedic Surgery Empire Orthopaedics PLLC 55 Spindrift Dr Ste 110 Williamsville NY 14221 Erie 7166321212

Ferrick, Michael R. Orthopedic Surgery University Orthopaedics Services Inc 219 Bryant St Buffalo NY 14222 Erie 7168787563

Ferrick, Michael R. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Ferrick, Michael R. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Ferrick, Michael R. Orthopedic Surgery Kaleida Health Haynes Annex 3435 Main St Buffalo NY 14214 Erie 7168293670

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 215 Klein Rd Buffalo NY 14221 Erie 7165686100

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7168293670

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 Orchard Park NY 14127 Erie 7168214400

Fineberg, Marc S. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

Fisher, David M. Orthopedic Surgery Fisher, David S 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7166624827

Fishkin, Zair Orthopedic Surgery Fishkin, Zair 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Galpin, Robert D. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Galpin, Robert D. Orthopedic Surgery University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 2nd Fl Orchard Park NY 14127 Erie 7168214400

Galpin, Robert D. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Galpin, Robert D. Orthopedic Surgery University Orthopaedics Services Inc 219 Bryant St Buffalo NY 14222 Erie 7168293670

Galpin, Robert D. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Galpin, Robert D. Orthopedic Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787331

Gambacorta, Peter L. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Buffalo NY 14221 Erie 7166361470

Gambacorta, Peter L. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Gambacorta, Peter L. Orthopedic Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787563

Gurske-De Perio, Jennifer Orthopedic Surgery University Orthopaedics Services Inc 3050 Orchard Pk Dr Building A West Seneca NY 14224 Erie 7166741884

Gurske-De Perio, Jennifer Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Gurske-De Perio, Jennifer Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

Gurske-De Perio, Jennifer Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166481128

Gurske-De Perio, Jennifer Orthopedic Surgery University Orthopaedics Services Inc 565 Abbott Rd Buffalo NY 142202039 Erie 7168282566

Hamill, Christopher L. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Hamill, Christopher L. Orthopedic Surgery University Orthopaedics Services Inc 100 College Pkwy Williamsville NY 142216800 Erie 7162040487

Hamill, Christopher L. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Buffalo NY 142031126 Erie 7168591256

Hlubik, Patrick J. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Hlubik, Patrick J. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7166361470

Huckell, Cameron B. Orthopedic Surgery Huckell, Cameron 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Huckell, Cameron B. Orthopedic Surgery Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Huckell, Cameron B. Orthopedic Surgery Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Huckell, Graham R. Orthopedic Surgery Huckell, Graham R. 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Huckell, Graham R. Orthopedic Surgery Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Huckell, Graham R. Orthopedic Surgery Simmons Orthopaedic Spine As 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 565 Abbot Rd Buffalo NY 14220 Erie 7168282566

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7166621435

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 2157 Main St Buffalo NY 14214 Erie 7168621910

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476096

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Buffalo NY 14203 Erie 7168591256

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Jones, Joshua L. Orthopedic Surgery University Orthopaedics Services Inc 215 Klein Rd Williamsville NY 14221 Erie 7165686100

Karpie, John C. Orthopedic Surgery Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Kowalski, Joseph M. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Kowalski, Joseph M. Orthopedic Surgery Kowalski, Joseph 462 Grider St Buffalo NY 14215 Erie 7168985588

Kowalski, Joseph M. Orthopedic Surgery University Orthopaedics Services Inc 2157 Main St Buffalo NY 14214 Erie 7168293670

Kowalski, Joseph M. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983414

Kowalski, Joseph M. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Ste 202 Buffalo NY 14226 Erie 7168107999

Krackow, Kenneth A. Orthopedic Surgery Kaleida Health 100 High St Ste B276 Buffalo NY 14203 Erie 7168591256

Krackow, Kenneth A. Orthopedic Surgery University Orthopaedics Services Inc 100 High St B 276 Buffalo NY 14203 Erie 7168591256

Page 97 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Krackow, Kenneth A. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Lanighan, Kevin W. Orthopedic Surgery Northtowns Orthopedics Pc 360 N Union Rd Williamsville NY 14221 Erie 7166361470

Lanighan, Kevin W. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Lapoint, Paul J. Orthopedic Surgery Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Leone, Anthony M. Orthopedic Surgery Leone, Anthony 192 Park Club Ln Ste 120 Buffalo NY 14221 Erie 7162041101

Lombardo Jr, Thomas A. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Lombardo Jr, Thomas A. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7166361470

Luzi, Frank A. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Luzi, Frank A. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7166361470

Marzo, John M. Orthopedic Surgery University Orthopaedics Services Inc 215 Klein Rd Williamsville NY 14221 Erie 7168293670

Marzo, John M. Orthopedic Surgery Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Marzo, John M. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Marzo, John M. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Marzo, John M. Orthopedic Surgery University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Mason, Paul J. Orthopedic Surgery Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Mata, Brian A. Orthopedic Surgery Lakeshore Orthopedic Group Pc Lakeshore Professional 550 Orchard Park Rd West Seneca NY 14224 Erie 7166774400

McGrath, Brian E. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

McGrath, Brian E. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Buffalo NY 14203 Erie 7168293670

McGrath, Brian E. Orthopedic Surgery University Orthopaedics Services Inc 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476096

McGrath, Brian E. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983810

McGrath, Brian E. Orthopedic Surgery University Orthopaedics Services Inc Elm and Carlton St Buffalo NY 14263 Erie 7168452300

McGrath, Brian E. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Miller, David T. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Miller, David T. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7166361470

Moscato, John A. Orthopedic Surgery Moscato, John 3552 Southwestern Blvd Orchard Park NY 14127 Erie 7166621221

Mutty, Christopher E. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Mutty, Christopher E. Orthopedic Surgery University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 2nd Fl Orchard Park NY 14127 Erie 7168214400

Mutty, Christopher E. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Mutty, Christopher E. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Mutty, Christopher E. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Nenno II, Donald J. Orthopedic Surgery Kaleida Health 100 High St Ste B276 Buffalo NY 14203 Erie 7168591256

Nenno II, Donald J. Orthopedic Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591246

Nenno II, Donald J. Orthopedic Surgery Western New York Orthopaedics Pc 468 Delaware Ave 2nd Fl Buffalo NY 14202 Erie 7168834201

Nichols, David P. Orthopedic Surgery Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Nichols, David P. Orthopedic Surgery Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Nichols, David P. Orthopedic Surgery Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Nichols, David P. Orthopedic Surgery Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Nichols, David P. Orthopedic Surgery Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

O Donnell, John L. Orthopedic Surgery O'Donnell, John 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7166628083

Ostempowski, Michael J. Orthopedic Surgery Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Parentis, Michael A. Orthopedic Surgery Keith L Stube Md Pr Knee Center Of 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7165088252

Parentis, Michael A. Orthopedic Surgery Keith L Stube Md Pr Knee Center Of 180 Park Club Ln Ste 225 Williamsville NY 14221 Erie 7168395858

Parentis, Michael A. Orthopedic Surgery Keith L Stube Md Pr Knee Center Of 180 Park Club Ln Ste 150 Williamsville NY 14221 Erie 7168395858

Paterson, Paul D. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983414

Paterson, Paul D. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Phillips, Matthew J. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Phillips, Matthew J. Orthopedic Surgery Kaleida Health 100 High St Ste B276 Buffalo NY 14203 Erie 7168591256

Phillips, Matthew J. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Road Amherst NY 14226 Erie 7168293670

Phillips, Matthew J. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Buffalo NY 14203 Erie 7168293670

Pochatko, David J. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Pochatko, David J. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7168390750

Pula, David A. Orthopedic Surgery David Pula MD PC 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7165088515

Rachala, Sridhar R. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Ste B276 Buffalo NY 14203 Erie 7168591256

Rachala, Sridhar R. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162013200

Rachala, Sridhar R. Orthopedic Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591250

Rachala, Sridhar R. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Rachala, Sridhar R. Orthopedic Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ratliff, David F. Orthopedic Surgery Northtowns Orthopedics Pc 2075 Sheridan Dr Kenmore NY 14223 Erie 7166361470

Ratliff, David F. Orthopedic Surgery Northtowns Orthopedics Pc 8750 Transit Rd Ste 105 East Amherst NY 14051 Erie 7166361470

Ratliff, David F. Orthopedic Surgery Northtowns Orthopedics Pc 2914 Elmwood Ave Kenmore Mercy Med Bldg Kenmore NY 14217 Erie 7166361470

Ratliff, David F. Orthopedic Surgery Northtowns Orthopedics Pc 36 N Union Rd Williamsville NY 14221 Erie 7166361470

Ratliff, David F. Orthopedic Surgery Northtowns Orthopedics Pc 1900 Ridge Rd West Seneca NY 14224 Erie 7166361470

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983000

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 2nd Fl Orchard Park NY 14127 Erie 7168214400

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Page 98 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7168293670

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 550 Orchard Pk Rd West Seneca NY 14224 Erie 7168293670

Rauh, Michael A. Orthopedic Surgery University Orthopaedics Services Inc 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7169470180

Rauh, Michael A. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Reed, Kory B. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Reed, Kory B. Orthopedic Surgery Excelsior Orthopaedics Llp 240 Red Tail Stes 1 and 2 Orchard Park NY 14127 Erie 7162509999

Repicci, John A. Orthopedic Surgery Repicci and Romanowski MD Inc 4510 Main St Amherst NY 14226 Erie 7168390632

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7168293670

Ritter, Christopher A. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 3671 Southwestern Blvd Ste 207 Orchard Park NY 14127 Erie 7168293670

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168293670

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14240 Erie 7168985506

Ritter, Christopher A. Orthopedic Surgery University Orthopaedics Services Inc 550 Orchard Pk Rd West Seneca NY 14224 Erie 7168293670

Roberto, Craig M. Orthopedic Surgery Frank J Schlehr MD PC 15 S Forest Rd Williamsville NY 14221 Erie 7166261824

Rohrbacher, Bernhard J. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Rohrbacher, Bernhard J. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Rohrbacher, Bernhard J. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7168293670

Rohrbacher, Bernhard J. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168984733

Romanowski, Marcus R. Orthopedic Surgery Repicci and Romanowski MD Inc 4510 Main St Amherst NY 14226 Erie 7168390632

Rycyna, Stephen D. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Santilli, Mario D. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Santilli, Mario D. Orthopedic Surgery University Orthopaedics Services Inc 3 Gates Cir Buffalo NY 14209 Erie 7168874690

Santilli, Mario D. Orthopedic Surgery University Orthopaedics Services Inc 100 High St Ste B276 Buffalo NY 14203 Erie 7168591256

Santilli, Mario D. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043250

Schlehr, Frank J. Orthopedic Surgery Frank J Schlehr MD PC 15 S Forest Rd Williamsville NY 14221 Erie 7166261824

Sherban, Ross Orthopedic Surgery Sherban Orthopaedics and Spine Surgery PLLC 2914 Elmwood Ave Kenmore NY 14217 Erie 7164476310

Sherban, Ross Orthopedic Surgery Sherban Orthopaedics and Spine Surgery PLLC 3673 Southwestern Blvd Orchard Park NY 14127 Erie 7164476310

Sherban, Ross Orthopedic Surgery Sherban Orthopaedics and Spine Surgery PLLC 55 Spindrift Dr Buffalo NY 14221 Erie 7164476310

Shields, Peter E. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Simmons, Edward D. Orthopedic Surgery Ross Sherban DO 235 North St Buffalo NY 14201 Erie 7168820035

Slough, James A. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Slough, James A. Orthopedic Surgery Kenmore Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7164476396

Smolinski, Robert J. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Smolinski, Robert J. Orthopedic Surgery University Orthopaedics Services Inc 550 ORCHARD PARK RD Buffalo NY 14224 Erie 7166774166

Smolinski, Robert J. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Smolinski, Robert J. Orthopedic Surgery University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Stegemann, Philip M. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983414

Stegemann, Philip M. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Stegemann, Philip M. Orthopedic Surgery University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168984734

Stoeckl, Andrew C. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Stoeckl, Andrew C. Orthopedic Surgery Excelsior Orthopaedics Llp 240 Red Tail Stes 1 and 2 Orchard Park NY 14127 Erie 7162509999

Stube, Keith C. Orthopedic Surgery Keith L Stube Md Pr Knee Center Of 180 Park Club Ln Ste 150 Williamsville NY 14221 Erie 7168395858

Stube, Keith C. Orthopedic Surgery Keith L Stube Md Pr Knee Center Of 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7165088252

Stube, Keith C. Orthopedic Surgery Keith L Stube Md Pr Knee Center Of 180 Park Club Ln Ste 225 Williamsville NY 14221 Erie 7168395858

Szarzanowicz, Thaddeus E. Orthopedic Surgery Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Szarzanowicz, Thaddeus E. Orthopedic Surgery Buffalo Orthopaedic Group LLP 224 E Main St Springville NY 14141 Erie 7165970748

Tetro, Andrew Marc Orthopedic Surgery Tetro, Andrew Marc 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Tetro, Andrew Marc Orthopedic Surgery Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Vigna, Franco E. Orthopedic Surgery Spine Surgery of Buffalo Niagara LLC 2914 Elmwood Ave Kenmore NY 14217 Erie 7166293338

Violante, Nicholas J. Orthopedic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983414

Violante, Nicholas J. Orthopedic Surgery Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Wild, Daniel R. Orthopedic Surgery Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166313041

Wilkins, Ryan D. Orthopedic Surgery Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476329

Wilkins, Ryan D. Orthopedic Surgery Repicci and Romanowski MD Inc 4510 Main St Buffalo NY 14226 Erie 7168390632

Wind Jr, William M. Orthopedic Surgery University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Wind Jr, William M. Orthopedic Surgery University Orthopaedics Services Inc 215 Klein Rd Williamsville NY 14221 Erie 7165686100

Wind Jr, William M. Orthopedic Surgery University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Wind Jr, William M. Orthopedic Surgery University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Wind Jr, William M. Orthopedic Surgery University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Zinno, Matthew J. Orthopedic Surgery Frank J Schlehr MD PC 15 S Forest Rd Williamsville NY 14221 Erie 7166261824

Behar, Philomena M. Otolaryngology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787368

Behar, Philomena M. Otolaryngology Pediatric ENT Associates 3580 Sheridan Dr Ste 115 Amherst NY 14226 Erie 7163629730

Behar, Philomena M. Otolaryngology Behar, Philomena 219 Bryant St Buffalo NY 14222 Erie 7163629730

Page 99 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Behar, Philomena M. Otolaryngology Behar, Philomena 3580 Sheridan Dr Ste 115 Amherst NY 14226 Erie 7163629730

Behar, Philomena M. Otolaryngology Pediatric ENT Associates 219 Bryant St Buffalo NY 14222 Erie 7163629730

Behar, Philomena M. Otolaryngology Pediatric ENT Associates 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7163629730

Belles, William J. Otolaryngology Belles, William J. 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168381100

Belles, William J. Otolaryngology Terrace View 462 Grider St Ste 154 Buffalo NY 14215 Erie 7168985667

Belles, William J. Otolaryngology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Bernstein, Joel M. Otolaryngology Delaware Medical Group 2430 N Forest Rd Getzville NY 14068 Erie 7166367613

Bernstein, Joel M. Otolaryngology Bernstein, Joel M. 2430 N Forest Rd Ste 150 Getzville NY 14068 Erie 7166367613

Buck, Steven H. Otolaryngology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Buck, Steven H. Otolaryngology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Campione, Peter A. Otolaryngology Mercy Hospital 2875 Union Rd Ste 8 Cheektowaga NY 14227 Erie 7166510911

Campione, Peter A. Otolaryngology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Campione, Peter A. Otolaryngology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Chmiel, James F. Otolaryngology Amherst Ear Nose And Throat LLC 3950 E Robinson Rd Ste 106 Amherst NY 14228 Erie 7166913500

Cipolla, Michael J. Otolaryngology WNY EAR NOSE & THROAT PC 3626 Seneca St West Seneca NY 14224 Erie 7166755711

Danziger, Iris R. Otolaryngology Euville LLP 6000 N Bailey Ave Amherst NY 14226 Erie 7168344522

Danziger, Iris R. Otolaryngology Amherst Southgate ENT LLP 6000 N Bailey Rd Amherst NY 14226 Erie 7167120855

Danziger, Iris R. Otolaryngology Amherst Southgate ENT LLP 1026 Union Rd Buffalo NY 14224 Erie 7167120855

Diaz Ordaz, Ernesto A. Otolaryngology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Diaz Ordaz, Ernesto A. Otolaryngology Buffalo Ent Specialists Llp 180 Park Club Ln Ste 200 Williamsville NY 14221 Erie 7166347350

Diaz Ordaz, Ernesto A. Otolaryngology Buffalo Ent Specialists Llp 12845 Broadway Alden NY 14004 Erie 7166347350

Diaz Reyes, Gustavo A. Otolaryngology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Diaz Reyes, Gustavo A. Otolaryngology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Gass, Frederick C. Otolaryngology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Gonzalez Doldan, Federico G. Otolaryngology Gonzalez-Doldan, Federico 585 Delaware St Tonawanda NY 14150 Erie 7166935005

Haar, Michael S. Otolaryngology Delaware Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Haben, Michael C. Otolaryngology Haben, Michael 1020 YoungsRd Ste 110 Williamsville NY 14221 Erie 7168837224

Hicks Jr, Wesley L. Otolaryngology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Hoeplinger, Mark A. Otolaryngology WNY EAR NOSE & THROAT PC 3626 Seneca St West Seneca NY 14224 Erie 7166755711

Jeyapalan, Gerald R. Otolaryngology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7168234962

Jeyapalan, Gerald R. Otolaryngology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301283

Jeyapalan, Gerald R. Otolaryngology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Le, Kien T. Otolaryngology Kaleida Health 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Le, Kien T. Otolaryngology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Le, Kien T. Otolaryngology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781364

Le, Kien T. Otolaryngology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Le, Kien T. Otolaryngology Kaleida Health 219 Bryant st Buffalo NY 14222 Erie 7168787000

Lee, Keun Y. Otolaryngology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Lee, Keun Y. Otolaryngology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Mandych, Alexander K. Otolaryngology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Miller, Justin D. Otolaryngology Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Miller, Justin D. Otolaryngology Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Miller, Justin D. Otolaryngology Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Miller, Justin D. Otolaryngology Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Miller, Justin D. Otolaryngology Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Miller, Robin Otolaryngology Miller, Robin 1275 Delaware Ave Buffalo NY 14209 Erie 7168831366

Muscarella Jr, Joseph L. Otolaryngology Buffalo Ent Specialists Llp 180 Park Club Ln Ste 200 Buffalo NY 14221 Erie 7166347350

Nabi, Sayeed Otolaryngology Erie Niagra Tonawanda Medical Associates Pc 6645 Main St Williamsville NY 14221 Erie 7166346224

Nagy, Mark L. Otolaryngology Pediatric ENT Associates 200 Sterling Pk Dr Orchard Park NY 14127 Erie 7168757569

Nagy, Mark L. Otolaryngology University At Buffalo Otolaryngology 550 Orchard Park Rd Ste B101 West Seneca NY 14224 Erie 7166322000

Nagy, Mark L. Otolaryngology University At Buffalo Otolaryngology 219 Bryant St Buffalo NY 14222 Erie 7168787368

Nagy, Mark L. Otolaryngology University At Buffalo Otolaryngology 8207 Main St Ste 5 Williamsville NY 14221 Erie 7166322000

Nagy, Mark L. Otolaryngology Pediatric ENT Associates 219 Bryant St Buffalo NY 14222 Erie 7163629730

Nagy, Mark L. Otolaryngology Nagy, Mark 219 Bryant St Buffalo NY 14222 Erie 7163629730

Nagy, Mark L. Otolaryngology University At Buffalo Otolaryngology 118 Hodge Buffalo NY 14222 Erie 7168787368

Nagy, Mark L. Otolaryngology University At Buffalo Otolaryngology 215 Klein Rd Williamsville NY 14221 Erie 7166322000

Nagy, Mark L. Otolaryngology Nagy, Mark 3580 Sheridan Dr Amherst NY 14226 Erie 7168787569

Nagy, Mark L. Otolaryngology Pediatric ENT Associates 3580 Sheridan Dr Ste 115 Amherst NY 14226 Erie 7163629730

Nagy, Mark L. Otolaryngology Pediatric ENT Associates 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7163629730

Nagy, Mark L. Otolaryngology Nagy, Mark 4721 Transit Rd Ste 323 Depew NY 14043 Erie 7168787569

Niemiec, Edward R. Otolaryngology Edward R Niemiec Md 315 Alberta Dr Amherst NY 14226 Erie 7168335100

O'Connell, Kevin A. Otolaryngology General Physician PC 517 Sunset Dr Hamburg NY 14075 Erie 7166462590

Paolini Jr, Raymond V. Otolaryngology Ear Nose and Throat Care of WNY Inc 6645 Main St Williamsville NY 14221 Erie 7166346224

Parikh, Parmanand K. Otolaryngology Niagara Medicine PC 2157 Main St Buffalo NY 14214 Erie 7168621965

Parikh, Parmanand K. Otolaryngology Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Parikh, Parmanand K. Otolaryngology Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Page 100 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Parikh, Parmanand K. Otolaryngology Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Parikh, Parmanand K. Otolaryngology Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168627000

Patterson, Dwight M. Otolaryngology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Pizzuto, Michael P. Otolaryngology University At Buffalo Otolaryngology 8207 Main St Ste 5 Williamsville NY 14221 Erie 7166322000

Pizzuto, Michael P. Otolaryngology University At Buffalo Otolaryngology 215 Klein Rd Williamsville NY 14221 Erie 7166322000

Pizzuto, Michael P. Otolaryngology University At Buffalo Otolaryngology 219 Bryant St Buffalo NY 14222 Erie 7168787368

Pizzuto, Michael P. Otolaryngology University At Buffalo Otolaryngology 118 Hodge Buffalo NY 14222 Erie 7168787368

Pizzuto, Michael P. Otolaryngology University At Buffalo Otolaryngology 550 Orchard Park Rd Ste B101 West Seneca NY 14224 Erie 7166322000

Poje, Christopher P. Otolaryngology Pediatric ENT Associates 2721 Transit Rd Ste 112 Elma NY 14059 Erie 7163629730

Poje, Christopher P. Otolaryngology Pediatric ENT Associates 3580 Sheridan Dr Ste 115 Amherst NY 14226 Erie 7163629730

Poje, Christopher P. Otolaryngology Pediatric ENT Associates 219 Bryant St Buffalo NY 14222 Erie 7163629730

Poje, Christopher P. Otolaryngology Poje, Christopher 3580 Sheridan Dr Ste 115 Amherst NY 14226 Erie 7163629730

Poje, Christopher P. Otolaryngology Poje, Christopher 4721 Transit Rd Depew NY 14043 Erie 7163629730

Popat, Saurin R. Otolaryngology Delaware Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Popat, Saurin R. Otolaryngology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Prince, Beverly C. Otolaryngology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983310

Reyes, Samuel A. Otolaryngology Buffalo Ent Specialists Llp 180 Park Club Ln Ste 200 Williamsville NY 14221 Erie 7166347350

Rigual, Nestor R. Otolaryngology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983073

Sherris, David A. Otolaryngology University At Buffalo Otolaryngology 1237 Delaware Ave Buffalo NY 14209 Erie 7168875105

Sobie, Stephen R. Otolaryngology Buffalo Medical Group 1020 Youngs Rd Ste 110 Williamsville NY 14221 Erie 7168836800

Sobie, Stephen R. Otolaryngology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168836800

Stachiw, Natalka D. Otolaryngology WNY EAR NOSE & THROAT PC 3626 Seneca St West Seneca NY 14224 Erie 7166755711

Stanievich, John F. Otolaryngology Buffalo Ent Specialists Llp 180 Park Club Ln Ste 200 Buffalo NY 14221 Erie 7166347350

Stanievich, John F. Otolaryngology Kaleida Health 219 Bryant St WCHOB ENT Clinic Buffalo NY 14222 Erie 7168781364

Stanievich, John F. Otolaryngology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Vogan, Jonathan C. Otolaryngology Southtowns Ear Nose & Throat Llp 3075 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166750616

Williams, Robert W. Otolaryngology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301188

Williams, Robert W. Otolaryngology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301150

Williams, Robert W. Otolaryngology Buffalo Medical Group 518 Abbott Rd Buffalo NY 14220 Erie 7168234962

Young, Paul R. Otolaryngology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Young, Paul R. Otolaryngology Paul R Young MD PLLC 4955 N Bailey Ave Ste 202 Amherst NY 14226 Erie 7168328500

Young, Paul R. Otolaryngology Terrace View 4955 Bailey Ave Amherst NY 14226 Erie 7166301000

Zimmer, Gregg L. Otolaryngology Amherst Ear Nose And Throat LLC 3950 E Robinson Rd Ste 106 Amherst NY 14228 Erie 7166913500

Biddle, Paul T. Pain Management Paul T Biddle, M.D., PLLC 200 Sterling Dr Ste 202 Orchard Park NY 14127 Erie 7166491613

Fattouch, Hany Pain Management Buffalo Anesthesia Assoc Pc 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Fattouch, Hany Pain Management Buffalo Anesthesia Assoc Pc 3925 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7162506520

Hitt, James M. Pain Management Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Jain, Gaurav Pain Management Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Jain, Gaurav Pain Management Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Peer, Gerald L. Pain Management Gerald L. Peer, MD 1230 Eggert Rd Amherst NY 14226 Erie 7168380640

Rajaee, Naghmeh Pain Management VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Arora, Gautam Pain Medicine Hens Neurology PC 1829 Maple Rd Ste 102 Williamsville NY 142212700 Erie 7162768375

Balti, Mohamad A. Pain Medicine Medical Associates Of The Tonawandas Pc 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Bansal, Pratibha Pain Medicine Bansal, Pratibha 3 Gates Cir Buffalo NY 14209 Erie 7166902008

Bansal, Pratibha Pain Medicine Bansal, Pratibha 1515 Kensington Ave Buffalo NY 14215 Erie 7164465900

Bansal, Pratibha Pain Medicine Bansal, Pratibha 200 Sterling Orchard Park NY 14127 Erie 7166902008

Dave, Nikita C. Pain Medicine Gosy & Associates Pain Treatment and Neurology LLP 100 College Pkwy Ste 220 Williamsville NY 14221 Erie 7166269900

Ditonto, Elizabeth D. Pain Medicine Ditonto, Elizabeth 462 Grider St Buffalo NY 14215 Erie 7168983215

Ditonto, Elizabeth D. Pain Medicine Ditonto, Elizabeth 338 Harris Hill Rd Ste 207 Buffalo NY 14221 Erie 7166344798

Ditonto, Elizabeth D. Pain Medicine Ditonto, Elizabeth 4949 Harlem Rd Cheektowaga NY 14225 Erie 7168983215

Gosy, Eugene J. Pain Medicine Gosy & Associates Pain Treatment and Neurology LLP 100 College Pkwy Ste 220 Williamsville NY 14221 Erie 7166269900

Harris, Juan Diego Pain Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Henry, Ashraf F. Pain Medicine Parkside Anesthesia Associates PC 2121 Main St Ste 111 Buffalo NY 14214 Erie 7168367510

Henry, Ashraf F. Pain Medicine Pain Management And Headache Medicine Pl Rte 5 7008 Erie Rd Derby NY 14047 Erie 7169479147

Henry, Ashraf F. Pain Medicine Pain Management And Headache Medicine Pl 4227 Maple Rd Amherst NY 14226 Erie 7168321107

Hsu, Bernard H. Pain Medicine Buffalo Pain Medicine PC 1412 Sweet Home Rd Ste 6 Buffalo NY 14228 Erie 7166885088

Hsu, Bernard H. Pain Medicine Buffalo Pain Medicine PC 4949 Harlem Rd Ste 301 Amherst NY 14228 Erie 7162043200

Koritz, Hans R. Pain Medicine Koritz, Hans 2949 Elmwood Ave Kenmore NY 14217 Erie 7168737246

Koritz, Hans R. Pain Medicine Koritz, Hans 2950 Elmwood Ave Kenmore Mercy Hosp Kenmore NY 14217 Erie 7164476100

Lema, Mark J. Pain Medicine Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Peer, Matthew G. Pain Medicine Gerald L. Peer, MD 1230 Eggert Rd Amherst NY 14226 Erie 7168380640

Rempel, Jacob Pain Medicine Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482180

Rempel, Jacob Pain Medicine Wagdy Ghaly Md Pc 425 Michigan Ave Buffalo NY 14203 Erie 7168482420

Santasiero, Ronald P. Pain Medicine Santasiero, Ronald 4535 Southwestern Blvd Ste 801 Hamburg NY 14075 Erie 7166466075

Waghmarae, Romanth Pain Medicine Waghmarae, Romanth 2950 Elmwood Ave Kenmore NY 14223 Erie 7164476100

Waghmarae, Romanth Pain Medicine Waghmarae, Romanth 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page 101 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Waghmarae, Romanth Pain Medicine Waghmarae, Romanth 6245 Sheridan Dr Ste 116 Williamsville NY 14221 Erie 7165151500

Waghmarae, Romanth Pain Medicine Waghmarae, Romanth 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912422

Waghmarae, Romanth Pain Medicine Waghmarae, Romanth 100 High St Buffalo NY 14203 Erie 7168595600

Waghmarae, Romanth Pain Medicine Waghmarae, Romanth 2157 Main St Buffalo NY 14214 Erie 7166344798

Rasalingam, Shivani Pediatric Allergy & Immu University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Rasalingam, Shivani Pediatric Allergy & Immu University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Buffalo NY 14222 Erie 7168787258

Balluz, Rula S. Pediatric Cardiology University at Buffalo Pediatric Associates Inc 140 Hodge St Buffalo NY 14222 Erie 7168787312

Balluz, Rula S. Pediatric Cardiology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787312

Gupta, Umang Pediatric Cardiology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787000

Gupta, Umang Pediatric Cardiology University at Buffalo Pediatric Associates Inc 4535 Southwestern Blvd Ste 712 Hamburg NY 14075 Erie 7168787312

Gupta, Umang Pediatric Cardiology University at Buffalo Pediatric Associates Inc 1404 Sweet Home Rd Stes 5 and 6 Amherst NY 14228 Erie 7168787312

Kovalenko, Oleg G. Pediatric Cardiology University at Buffalo Pediatric Associates Inc 140 Hodge St Buffalo NY 14222 Erie 7168787300

Kovalenko, Oleg G. Pediatric Cardiology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787300

Leonard Jr, Glenn T. Pediatric Cardiology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Leonard Jr, Glenn T. Pediatric Cardiology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Leonard Jr, Glenn T. Pediatric Cardiology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621501

Leonard Jr, Glenn T. Pediatric Cardiology Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Menon, Vijayan A. Pediatric Cardiology Pediatric Cardiology Associates 936 Delaware Ave Ste 100 Buffalo NY 14209 Erie 7168855437

Menon, Vijayan A. Pediatric Cardiology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Menon, Vijayan A. Pediatric Cardiology Pediatric Cardiology Associates 1540 Maple Rd Williamsville NY 14221 Erie 7168855437

Menon, Vijayan A. Pediatric Cardiology Pediatric Cardiology Associates 545 Abbott Rd Buffalo NY 14202 Erie 7168855437

Menon, Vijayan A. Pediatric Cardiology Pediatric Cardiology Associates 219 Bryant St Buffalo NY 14222 Erie 7168855437

Menon, Vijayan A. Pediatric Cardiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Orie, Joseph D. Pediatric Cardiology Pediatric Cardiology Associates 50 High St Buffalo NY 14203 Erie 7168855437

Orie, Joseph D. Pediatric Cardiology Pediatric Cardiology Associates 936 Delaware Ave Ste 100 Buffalo NY 14209 Erie 7168855437

Orie, Joseph D. Pediatric Cardiology Pediatric Cardiology Associates 219 Bryant St Buffalo NY 14222 Erie 7168855437

Orie, Joseph D. Pediatric Cardiology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Orie, Joseph D. Pediatric Cardiology Pediatric Cardiology Associates 1540 Maple Rd Williamsville NY 14221 Erie 7168855437

Orie, Joseph D. Pediatric Cardiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Orie, Joseph D. Pediatric Cardiology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Orie, Joseph D. Pediatric Cardiology Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476412

Orie, Joseph D. Pediatric Cardiology Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Orie, Joseph D. Pediatric Cardiology Pediatric Cardiology Associates 545 Abbott Rd Buffalo NY 14202 Erie 7168855437

Orie, Joseph D. Pediatric Cardiology Pediatric Cardiology Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7168855437

Al Ibrahim, Omar S. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787442

Breuer, Ryan K. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787442

Dull, Maude E. Pediatric Critical Care Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Dull, Maude E. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787109

Dull, Maude E. Pediatric Critical Care Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592573

Hassinger, Amanda B. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787442

Heard, Christopher M. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787442

Heard, Christopher M. Pediatric Critical Care Great Lakes Anesthesiology 219 Bryant St Buffalo NY 14222 Erie 7168787701

Hereth, James R. Pediatric Critical Care Kaleida Health 100 High St Buffalo NY 14203 Erie 7168594024

Hereth, James R. Pediatric Critical Care Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Hereth, James R. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Critical Care Buffalo NY 14222 Erie 7168787442

Joshi, Prashant Pediatric Critical Care University Emergency Medical Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Joshi, Prashant Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787442

Kramer, Bree C. Pediatric Critical Care University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Derr, Robert M. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Byrant St Buffalo NY 14222 Erie 7168787349

Derr, Robert M. Pediatric Emergency Med MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Emborsky, Mary E. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168396720

Emborsky, Mary E. Pediatric Emergency Med MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Kenyon, Mark A. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant Buffalo NY 14240 Erie 7168396720

Kenyon, Mark A. Pediatric Emergency Med MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Lawrence, Lynn M. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787109

Lillis, Kathleen A. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168396720

Lillis, Kathleen A. Pediatric Emergency Med Pediatric and Adolescent Urgent Care of WNY 1800 Maple Rd Williamsville NY 14221 Erie 7166365437

Lillis, Kathleen A. Pediatric Emergency Med Pediatric and Adolescent Urgent Care of WNY 3055 Southwestern Blvd Orchard Park NY 14127 Erie 7166365437

Mazur, Paula Pediatric Emergency Med MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Mazur, Paula Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Penque, Michelle D. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168396720

Penque, Michelle D. Pediatric Emergency Med MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Tyo, John M. Pediatric Emergency Med MedFirst Urgent Care PLLC 3245 Southwestern Blvd Orchard Park NY 14127 Erie 7166918838

Tyo, John M. Pediatric Emergency Med University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168787109

Albini, Christine H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Albini, Christine H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Page 102 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Albini, Christine H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787588

Albini, Christine H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St First Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787588

Bethin, Kathleen E. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787588

Bethin, Kathleen E. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Bethin, Kathleen E. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Buchlis, John G. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1st Fl Ste 1a and 1b 140 Hodge St Buffalo NY 14222 Erie 7168787588

Buchlis, John G. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Buchlis, John G. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Danilovich, Nadezhda L. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Danilovich, Nadezhda L. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Flr Buffalo NY 14222 Erie 7168787588

Fourtner, Shannon H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Fourtner, Shannon H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Ste 1a 1b Buffalo NY 14222 Erie 7168787588

Fourtner, Shannon H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 4535 Southwestern Blvd Ste 712 Hamburg NY 14075 Erie 7168787588

Fourtner, Shannon H. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Gartner, Lou Ann M. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Buffalo NY 14222 Erie 7168787588

Gartner, Lou Ann M. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Gartner, Lou Ann M. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Majumdar, Indrajit Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Buffalo NY 14222 Erie 7168787588

Majumdar, Indrajit Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Majumdar, Indrajit Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Mastrandrea, Lucy D. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Mastrandrea, Lucy D. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Mastrandrea, Lucy D. Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Ste 1a 1b Buffalo NY 14222 Erie 7168787588

Quattrin, Teresa Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787588

Quattrin, Teresa Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787588

Quattrin, Teresa Pediatric Endocrinology University at Buffalo Pediatric Associates Inc PO Box 2113 Buffalo NY 14222 Erie 7168781570

Quattrin, Teresa Pediatric Endocrinology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Alkhouri, Razan H. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1404 Sweet Home Rd Ste 5 Buffalo NY 14228 Erie 7168787793

Alkhouri, Razan H. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Buffalo NY 14222 Erie 7168787793

Alkhouri, Razan H. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Baker, Robert D. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 200 Sterling Dr Orchard Park NY 14127 Erie 7168787793

Baker, Robert D. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787793

Baker, Robert D. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168396720

Baker, Robert D. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 3580 Sheridan Dr Amherst NY 14226 Erie 7168787793

Baker, Robert D. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787793

Baker, Susan S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Stes 5 and 6 Amherst NY 14226 Erie 7168787793

Baker, Susan S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 140 Hodge Ave Stes 1A and 1B Buffalo NY 14222 Erie 7168787793

Baker, Susan S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 200 Sterling Dr Orchard Park NY 14127 Erie 7168787793

Baker, Susan S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc Gastroenterology Division 219 Bryant St Buffalo NY 14222 Erie 7168787793

Borowitz, Drucy S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1400 1403 Sweethome Rd Amherst NY 14226 Erie 7168787561

Borowitz, Drucy S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787561

Borowitz, Drucy S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787561

Borowitz, Drucy S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 3580 Sheridan Dr Amherst NY 14226 Erie 7168787793

Borowitz, Drucy S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 3580 Sheridan Dr Childrens Amherst Hlth Ctr Buffalo NY 14226 Erie 7168787524

Desai, Sonal S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1404 Sweet Home Rd Ste 5 and 6 Buffalo NY 14228 Erie 7168787793

Desai, Sonal S. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787793

Gelfond, Daniel Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 6 Amherst NY 14226 Erie 7168787793

Gelfond, Daniel Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1st Fl Ste 1a 1b 140 Hodge Ave Buffalo NY 14222 Erie 7168787793

Gelfond, Daniel Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc Gastroenterology Division 219 Bryant St Buffalo NY 14222 Erie 7168787793

Gelfond, Daniel Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 200 Sterling Dr Orchard Park NY 14127 Erie 7168787793

Hashmi, Humaira Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787105

Hashmi, Humaira Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 200 Sterling Dr Orchard Park NY 14127 Erie 7168787793

Hashmi, Humaira Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc Gastroenterology Division 219 Bryant St Buffalo NY 14222 Erie 7168787793

Hashmi, Humaira Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787793

Srivastava, Maya D. Pediatric Gastroenterology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787105

Srivastava, Maya D. Pediatric Gastroenterology Srivastava, Maya 1000 Youngs Rd Ste 208 Williamsville NY 14221 Erie 7166880525

Ambrusko, Steven J. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787349

Ambrusko, Steven J. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787349

Ambrusko, Steven J. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 936 Delaware Ave 3rd Fl Buffalo NY 14209 Erie 7168962470

Bambach, Barbara J. Pediatric Hem-Onco Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Barth, Matthew L. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl ste 1A and 1B Buffalo NY 14222 Erie 7168787348

Barth, Matthew L. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787348

Barth, Matthew L. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 4535 Southwestern Blvd Ste 712 Hamburg NY 14075 Erie 7168787349

Beaupin, Lynda M. Pediatric Hem-Onco Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Brecher, Martin L. Pediatric Hem-Onco Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Fitzpatrick, Lorna K. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787349

Page 103 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Fitzpatrick, Lorna K. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Byrant St Buffalo NY 14222 Erie 7168787349

Higman, Meghan A. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Byrant St Buffalo NY 14222 Erie 7168787349

Higman, Meghan A. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 1st Fl Ste 1a and 1b 140 Hodge Ave Buffalo NY 14222 Erie 7168787349

Higman, Meghan A. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Bryant St Womens and Childrens Hosp Of Bfl Buffalo NY 14222 Erie 7168781081

Higman, Meghan A. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 1404 Sweethome Rd Ste 5 and 6 Amherst NY 14226 Erie 7168787588

Jain, Shilpa Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 140 Hodge Ave Stes 1A And 1B Buffalo NY 14222 Erie 7168787349

Jain, Shilpa Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787349

Rokitka, Denise A. Pediatric Hem-Onco University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Rokitka, Denise A. Pediatric Hem-Onco Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Faden, Howard S. Pediatric Infectious Dis University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787312

Hicar, Mark D. Pediatric Infectious Dis University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Ogra, Pearay L. Pediatric Infectious Dis Ogra, Pearay 219 Bryant St Buffalo NY 14222 Erie 7168787312

Ogra, Pearay L. Pediatric Infectious Dis University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787312

Garimella, Sudha Pediatric Nephrology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787109

Kallash, Mahmoud Pediatric Nephrology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787275

Kallash, Mahmoud Pediatric Nephrology University at Buffalo Pediatric Associates Inc 1404 Sweet Home Rd Ste 5 and 6 Amherst NY 14228 Erie 7168787275

Waz, Wayne R. Pediatric Nephrology University at Buffalo Pediatric Associates Inc 219 Bryant St Nephrology Dept Buffalo NY 14222 Erie 7168787275

Callanan, Vincent P. Pediatric Otolaryngology Kaleida Health 1001 Humboldt Pkwy Buffalo NY 14208 Erie 7168664400

Callanan, Vincent P. Pediatric Otolaryngology General Physician PC 7060 Erie Rd Derby NY 14047 Erie 7162130025

Callanan, Vincent P. Pediatric Otolaryngology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Khan, Abdur R. Pediatric Pathology University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168292846

Khan, Abdur R. Pediatric Pathology University at Buffalo Pathologists PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Bye, Michael R. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Bye, Michael R. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Buffalo NY 14222 Erie 7168787561

Concepcion, Emily R. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787561

Concepcion, Emily R. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 140 Hodge St Stes 1A-1B Buffalo NY 14222 Erie 7168787561

Goetz, Danielle M. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Goetz, Danielle M. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Buffalo NY 14222 Erie 7168787561

Sheehan, Daniel W. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 1031 Michigan Ave Buffalo NY 14203 Erie 7168787561

Sheehan, Daniel W. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 140 Hodge Ave 1st Fl Ste 1a and 1b Buffalo NY 14222 Erie 7168787561

Sheehan, Daniel W. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787561

Sheehan, Daniel W. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 1001 Humboldt Pkwy Buffalo NY 14208 Erie 7168864400

Sheehan, Daniel W. Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 1400 1403 Sweethome Rd Amherst NY 14226 Erie 7168787561

Singh, Shipra Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 140 Hodge St Buffalo NY 14222 Erie 7168787561

Singh, Shipra Pediatric Pulmonology University at Buffalo Pediatric Associates Inc 1404 Sweet Home Rd Amherst NY 14228 Erie 7168787561

Agrons, Geoffrey A. Pediatric Radiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Gupta, Puneet Pediatric Radiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Gupta, Puneet Pediatric Radiology Kaleida Health 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7168787502

Hanahan, Laura J. Pediatric Radiology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Polisoto, Thomas D. Pediatric Rehabilitation Med Polisoto, Thomas 550 Orchard Park Rd Bldg C West Seneca NY 14224 Erie 7168985059

Polisoto, Thomas D. Pediatric Rehabilitation Med Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Polisoto, Thomas D. Pediatric Rehabilitation Med University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168396720

Calkins, Joan G. Pediatric Rheumatology Village Pediatrics & Rheumatology 17 Long Ave Ste 110 Hamburg NY 14075 Erie 7166465188

Hennon, Teresa R. Pediatric Rheumatology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781689

Jarvis, James N. Pediatric Rheumatology University at Buffalo Pediatric Associates Inc 140 Hodge St 1st Fl Ste 1A and 1B Buffalo NY 14222 Erie 7168787105

Jarvis, James N. Pediatric Rheumatology University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7169326064

Jarvis, James N. Pediatric Rheumatology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Jarvis, James N. Pediatric Rheumatology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781689

Bass, Kathryn D. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Bass, Kathryn D. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Bass, Kathryn D. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Glick, Philip L. Pediatric Surgery University at Buffalo Surgeons Inc 3580 Sheridan Dr Buffalo NY 14226 Erie 7168593371

Glick, Philip L. Pediatric Surgery University at Buffalo Pediatric Surgical 219 Bryant St Dept Of Ped Surg Buffalo NY 14222 Erie 7168787449

Harmon, Carroll M. Pediatric Surgery Kaleida Health 219 Bryant St 2nd Fl Buffalo NY 14222 Erie 7168787874

Harmon, Carroll M. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Lee, Yi Horng Pediatric Surgery University at Buffalo Surgeons Inc 219 Bryant St Buffalo NY 14222 Erie 7168787137

Lee, Yi Horng Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Rothstein, David H. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Rothstein, David H. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Savo, Anthony M. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Savo, Anthony M. Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Vali, Kaveh Pediatric Surgery Kaleida Health 219 Bryany St Buffalo NY 14222 Erie 7168787000

Vali, Kaveh Pediatric Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Williot, Pierre E. Pediatric Urology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781260

Williot, Pierre E. Pediatric Urology Pediatric Urology of Western New York PC 240 Redtail Ln Ste 5 and 6 Orchard Park NY 14127 Erie 7168787393

Williot, Pierre E. Pediatric Urology Pediatric Urology of Western New York PC 3580 Sheridan Dr Eggertsville NY 14226 Erie 7168787393

Page 104 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Williot, Pierre E. Pediatric Urology Pediatric Urology of Western New York PC 219 Bryant St Buffalo NY 14222 Erie 7168787393

Albert, George P. Pediatrics Buffalo Neonatology Associates 565 Abbott Rd Buffalo NY 14220 Erie 7166344798

Albert, George P. Pediatrics Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Albert, George P. Pediatrics Buffalo Neonatology Associates 2157 Main St Buffalo NY 14214 Erie 7166344798

Albert, George P. Pediatrics Sisters of Charity Hospital : St Joseph Campus 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166923302

Bartels, Matthew F. Pediatrics Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Amherst NY 14226 Erie 7166890040

Bezbatchenko, Mark D. Pediatrics Lancaster Depew Pediatrics 5330 Genesee St Bowmansville NY 14026 Erie 7166846140

Bowman, Lori A. Pediatrics Orchard Park Pediatrics Pc 3725 N Buffalo Rd Ste A Orchard Park NY 14127 Erie 7166622300

Canavan, J William Pediatrics Kaleida Health 556 Franklin St Buffalo NY 14202 Erie 7168865437

Canavan, J William Pediatrics Springville Pediatric & Adult Care LLP 25 E Main St Springville NY 14141 Erie 7165922832

Cardone, Linda A. Pediatrics Delaware Pediatrics Associate 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Cardone, Linda A. Pediatrics Delaware Pediatrics Associate 4845 Transit Rd Depew NY 14043 Erie 7168840230

Conley, Danielle M. Pediatrics Allentown Pediatric/Adolescent Medicine, 560 Franklin St Buffalo NY 14202 Erie 7163324472

Cook, Sarah A. Pediatrics Lakeshore Primary Care Associates LLP 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166461084

Davis, Elizabeth Pediatrics Lancaster Depew Pediatrics 5330 Genesee St Bowmansville NY 14026 Erie 7166846140

Deluca, Nicole M. Pediatrics Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

D'Eon, Lisette A. Pediatrics Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922891

D'Eon, Lisette A. Pediatrics Keystone Hospitalist Service of NY PC 224 E Main St Springville NY 14141 Erie 7165922871

Dyson, Kathleen M. Pediatrics Orchard Park Pediatrics Pc 3725 N Buffalo Rd Ste A Orchard Park NY 14127 Erie 7166622300

Dzik, Darlene A. Pediatrics Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Dzik, Darlene A. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 2865 Genesee St Cheektowaga NY 14225 Erie 7168955437

Dzik, Darlene A. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 4899 Transit Rd Depew NY 14043 Erie 7165585437

Dzik, John A. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 2865 Genesee St Cheektowaga NY 14225 Erie 7168952590

Dzik, John A. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 4899 Transit Rd Depew NY 14043 Erie 7165585437

Ehlenfield, Daryl R. Pediatrics Allentown Pediatric/Adolescent Medicine, 560 Franklin St Buffalo NY 14202 Erie 7163324472

Ehrig, Debra L. Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ehrig, Debra L. Pediatrics Springville Pediatric & Adult Care LLP 25 E Main St Springville NY 14141 Erie 7165922832

Farghaly, Ayman A. Pediatrics Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Fischbeck, Susan Pediatrics Springville Pediatric & Adult Care LLP 25 E Main St Springville NY 14141 Erie 7165922832

Fretz, Stephanie H. Pediatrics Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Fretz, Stephanie H. Pediatrics Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Fretz, Stephanie H. Pediatrics Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166683600

Gellman, Wendy I. Pediatrics Forestream Pediatrics 4711 Transit Rd Ste 1 Depew NY 14043 Erie 7166685331

Goodman, Gail R. Pediatrics Southwestern Medical Associates 3675 Southwestern Blvd Orchard Park NY 14127 Erie 7169720279

Hansen, Robbin H. Pediatrics Springville Pediatric & Adult Care LLP 25 E Main St Springville NY 14141 Erie 7165922832

Heidelberger, Edwin Pediatrics Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Hogan, Harriette F. Pediatrics Delaware Pediatrics Associate 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Kasnicki, Laurie Pediatrics Kidsalliance Pediatric Group LLP 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7169958801

Kasnicki, Laurie Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kasnicki, Laurie Pediatrics Century-Airport Pediatrics Pc 2625 Harlem Rd Ste 210 Cheektowaga NY 14225 Erie 7168937337

Kaul, Tej N. Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Mercy Hospital Buffalo NY 14220 Erie 7168267000

Kita, Joseph T. Pediatrics Carrow Street Pediatrics PLLC 24 Carrow St Orchard Park NY 14127 Erie 7166623443

Krol, Lawrence C. Pediatrics Delaware Pediatrics Associate 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Krol, Lawrence C. Pediatrics Delaware Pediatrics Associate 4845 Transit Rd Depew NY 14043 Erie 7168840230

Krzan Jr, John J. Pediatrics Hamburg Pediatrics, P.C. 4390 Quinby Dr Ste E Hamburg NY 14075 Erie 7163127400

Kuwik, Lauren M. Pediatrics O'Connor Medical Group LLP 3075 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7167120490

Lana, Steven J. Pediatrics Delaware Pediatrics Associate 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Lana, Steven J. Pediatrics Delaware Pediatrics Associate 4845 Transit Rd Depew NY 14043 Erie 7168840230

McGravey, Vincent J. Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

McGravey, Vincent J. Pediatrics Kidsalliance Pediatric Group LLP 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7169958801

McGravey, Vincent J. Pediatrics Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282437

Menchini, John P. Pediatrics Delaware Pediatrics Associate 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

O Connor, Terence P. Pediatrics O'Connor Medical Group LLP 3075 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7167120490

Palma, Alessandra M. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 2865 Genesee St Cheektowaga NY 14225 Erie 7168952590

Palma, Alessandra M. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 4899 Transit Rd Depew NY 14043 Erie 7165585437

Perry, Mark F. Pediatrics Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Prise, Kimberly B. Pediatrics Forestream Pediatrics 4711 Transit Rd Ste 1 Depew NY 14043 Erie 7166685331

Rabice, Michael D. Pediatrics Lancaster Depew Pediatrics 5330 Genesee St Bowmansville NY 14026 Erie 7166846140

Raiken, Deborah F. Pediatrics Allentown Pediatric/Adolescent Medicine, 560 Franklin St Buffalo NY 14202 Erie 7163324472

Reimer, Tara L. Pediatrics Carrow Street Pediatrics PLLC 24 Carrow St Orchard Park NY 14127 Erie 7166623443

Roller, Jennifer L. Pediatrics Century-Airport Pediatrics Pc 515 ABBOTT RD STE 304 Buffalo NY 14220 Erie 7169958801

Roller, Jennifer L. Pediatrics Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Roller, Jennifer L. Pediatrics Century-Airport Pediatrics Pc 2625 Harlem Rd Ste 210 Cheektowaga NY 14225 Erie 7168937337

Roller, Jennifer L. Pediatrics Kidsalliance Pediatric Group LLP 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7169958801

Samra, Avtar S. Pediatrics Chelikani Varma, MD 6240 Transit Rd Depew NY 14043 Erie 7166813434

Samra, Avtar S. Pediatrics Kenmore Mercy Hospital 300 Two Mile Crk Rd Tonawanda NY 14150 Erie 7164476450

Page 105 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Schenk, Thomas E. Pediatrics Mercy Hospital 525 Abbott Rd Buffalo NY 14220 Erie 7168282775

Schenk, Thomas E. Pediatrics Delaware Pediatrics Associate 4845 Transit Rd Depew NY 14043 Erie 7168840230

Schenk, Thomas E. Pediatrics Enterprise Health Services 275 Oak St Buffalo NY 14203 Erie 7169611542

Schenk, Thomas E. Pediatrics Delaware Pediatrics Associate 2550 Delaware Ave Buffalo NY 14216 Erie 7168840230

Schenk, Thomas E. Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Schreck, Frank T. Pediatrics Orchard Park Pediatrics Pc 3725 N Buffalo Rd Ste A Orchard Park NY 14127 Erie 7166622300

Schulman, Robert J. Pediatrics Sisters of Charity Hospital : St Joseph Campus 430 Southside Pkwy Buffalo NY 14210 Erie

Schulman, Robert J. Pediatrics Robert Schulman MD 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Schulman, Robert J. Pediatrics Robert Schulman MD 2157 Main St Buffalo NY 14214 Erie 7168622000

Schulman, Robert J. Pediatrics Kenmore Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7166685331

Schulman, Robert J. Pediatrics Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476489

Schulman, Robert J. Pediatrics Robert Schulman MD 219 Bryant St Buffalo NY 14222 Erie 7168787000

Sickels, Eric G. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 4899 Transit Rd Depew NY 14043 Erie 7165585437

Sickels, Eric G. Pediatrics Genesee Transit Pediatric Llp C/O Healthtec Soluti 2865 Genesee St Cheektowaga NY 14225 Erie 7168952590

Springer, Christopher R. Pediatrics Kidsalliance Pediatric Group LLP 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7169958801

Steinacher, Robyn S. Pediatrics Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Stidham, Lynda M. Pediatrics Springville Pediatric & Adult Care LLP 25 E Main St Springville NY 14141 Erie 7165922832

Stouter, Barbara S. Pediatrics Kidsalliance Pediatric Group LLP 515 Abbott Rd Ste 304 Buffalo NY 14220 Erie 7169958801

Terranova, Michael D. Pediatrics Lancaster Depew Pediatrics 5330 Genesee St Bowmansville NY 14026 Erie 7166846140

Vergos, Katherine A. Pediatrics Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Vetrano, Anthony T. Pediatrics Century-Airport Pediatrics Pc 2625 Harlem Rd Ste 210 Cheektowaga NY 14225 Erie 7168937337

Vetrano, Anthony T. Pediatrics Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Vetrano, Anthony T. Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Wang, Gloria Pediatrics Mercy Hospital 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Wegman, Theresa M. Pediatrics Carrow Street Pediatrics PLLC 24 Carrow St Orchard Park NY 14127 Erie 7166623443

Weiss, Steven D. Pediatrics Carrow Street Pediatrics PLLC 24 Carrow St Orchard Park NY 14127 Erie 7166623443

Welliver, Josephine R. Pediatrics Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Welliver, Josephine R. Pediatrics Century-Airport Pediatrics Pc 2625 Harlem Rd Ste 210 Cheektowaga NY 14225 Erie 7168937337

Welliver, Josephine R. Pediatrics Kidsalliance Pediatric Group LLP 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Azaula, Melissa A. Physical Med & Rehab University at Buffalo Pediatric Associates Inc Division Of Developmental And Rehabilita 219 Bryant St Buffalo NY 14222 Erie 7168787440

Azaula, Melissa A. Physical Med & Rehab Azaula, Melissa 936 Delaware Ave Buffalo NY 14209 Erie 7168787756

Azaula, Melissa A. Physical Med & Rehab Kaleida Health 936 Delaware Ave Buffalo NY 14209 Erie 7168781260

Azaula, Melissa A. Physical Med & Rehab University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168781268

Bagnall, David L. Physical Med & Rehab David L Bagnall MD PC 3980A Sheridan Dr Ste 102 Amherst NY 14226 Erie 7162506545

Bagnall, David L. Physical Med & Rehab Ellen M Battista 3980 A Sheridan Dr Ste 102 Amherst NY 14226 Erie 7162506545

Beaupin, Bernard R. Physical Med & Rehab Beaupin, Bernard R. 565 Abbot Rd Buffalo NY 14220 Erie 7168267000

Beaupin, Bernard R. Physical Med & Rehab Bernard Beaupin MD PLLC 2914 Elmwood Ave Ste 3 Buffalo NY 14217 Erie 7164476936

Boucher, George P. Physical Med & Rehab George P Boucher MD 515 Abbott Rd Marian Blvd Ste 400 Buffalo NY 14220 Erie 7166344798

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 425 Meyer Rd West Seneca NY 14224 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 2075 Sheridan Dr Kenmore NY 14223 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Snyder NY 14226 Erie 7166260093

Cicchetti, Corine S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 500 Orchard Park NY 14127 Erie 7166260093

Cicchetti, Michael S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 500 Orchard Park NY 14127 Erie 7166260093

Cicchetti, Michael S. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Cicchetti, Michael S. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Cicchetti, Michael S. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Cicchetti, Michael S. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Cowan, Thomas B. Physical Med & Rehab Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 450 Central Ave Lancaster NY 14086 Erie 7166816768

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 345 Dick Rd Depew NY 14043 Erie 7166813333

Czyrny, James J. Physical Med & Rehab James J Czyrny Md 207 Commerce Dr Buffalo NY 14228 Erie 7166891901

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 462 Grider St Buffalo NY 14215 Erie 7168983106

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 5110 Camp Rd Hamburg NY 14075 Erie 7166499200

Czyrny, James J. Physical Med & Rehab American Neuromonitoring Asso 462 Grider St Buffalo NY 14215 Erie 7168983106

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 2360 Sweet Home Rd Buffalo NY 14228 Erie 7165648800

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043291

Czyrny, James J. Physical Med & Rehab University Orthopaedics Services Inc 3925 Sheridan Dr Buffalo NY 14226 Erie 7162509999

Ertel, Bradley R. Physical Med & Rehab Ertel, Bradley R. 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fry, Deborah A. Physical Med & Rehab Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166924342

Fry, Deborah A. Physical Med & Rehab Deborah Anne Fry 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476565

Fung, Tat S. Physical Med & Rehab Grider Medical Services PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Page 106 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Fung, Tat S. Physical Med & Rehab Rehabilitation Physician Services of Erie County PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Fung, Tat S. Physical Med & Rehab Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7179893000

Geraci Jr, Michael C. Physical Med & Rehab MedFirst Urgent Care PLLC 4827 Transit Rd Depew NY 14043 Erie 7167713394

Geraci Jr, Michael C. Physical Med & Rehab Michael C Geraci Jr MD PC 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Geraci Jr, Michael C. Physical Med & Rehab MedFirst Urgent Care PLLC 3980 Sheridan Dr Amherst NY 14226 Erie 7166918838

Geraci Jr, Michael C. Physical Med & Rehab Michael C Geraci Jr MD PC 3980 Sheridan Dr Amherst NY 14226 Erie 7169292800

Geraci Jr, Michael C. Physical Med & Rehab Michael C Geraci Jr MD PC 52 S Union Rd Ste 202 Williamsville NY 14221 Erie 7162475320

Geraci Jr, Michael C. Physical Med & Rehab MedFirst Urgent Care PLLC 5965 Transit Rd East Amherst NY 14051 Erie 7163621093

Geraci Jr, Michael C. Physical Med & Rehab Michael C Geraci Jr MD PC 4827 Transit Rd Depew NY 14043 Erie 7167713283

Jerzewski, Aaron J. Physical Med & Rehab Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Jerzewski, Aaron J. Physical Med & Rehab Kaleida Health 100 High St Physiatry Clinic Buffalo NY 14203 Erie 7168597177

Joki, Jaclyn Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Kaplan, Leonard Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Kaplan, Leonard Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Kaplan, Leonard Physical Med & Rehab Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Amherst NY 14226 Erie 7166260093

Kaplan, Leonard Physical Med & Rehab Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Kaplan, Leonard Physical Med & Rehab Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 400 Orchard Park NY 14127 Erie 7166774484

Kaplan, Leonard Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Kaplan, Leonard Physical Med & Rehab Buffalo Spine & Sports Medicine PC 425 Meyer Rd West Seneca NY 14224 Erie 7166260093

Kauderer, Mary C. Physical Med & Rehab Paul Bulger Vision Rehabilitation Clinic 1170 Main St Buffalo NY 14209 Erie 7168884556

Kauderer, Mary C. Physical Med & Rehab Buffalo Medical Group 495 International Dr Williamsville NY 14221 Erie 7166301221

Kauderer, Mary C. Physical Med & Rehab Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301290

Kauderer, Mary C. Physical Med & Rehab Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301290

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 2950 Elmwood Ave Kenmore Mercy Hospital Kenmore NY 14217 Erie 7164476021

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 2075 Kensington Ave Snyder NY 14226 Erie 7168393717

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912703

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 550 Orchard Park Rd Bldg C 2nd Fl West Seneca NY 14224 Erie 7168613364

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 2914 Elmwood Ave Ste 2 Kenmore NY 14217 Erie 7168613364

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 550 Orchard Park Rd Bldg C Buffalo NY 14224 Erie 7166775000

Koenig, Jeannie K. Physical Med & Rehab Jeannie Kao Koenig, M.D., PLLC 1503 Military Rd McAuley Residence Kenmore NY 14217 Erie 7164476600

Kuruvilla, Philip T. Physical Med & Rehab Buffalo Medical Group 425 Essjay Rd Buffalo NY 14221 Erie 7166301136

Kuruvilla, Philip T. Physical Med & Rehab Buffalo Medical Group 295 Essjay Rd Buffalo NY 14221 Erie 7166301000

Kuruvilla, Philip T. Physical Med & Rehab University Physical Medicine & Rehab 4949 Harlem Rd Buffalo NY 14226 Erie 7168874600

Kuruvilla, Philip T. Physical Med & Rehab University Physical Medicine & Rehab 100 High St Buffalo NY 14203 Erie 7168595600

Kuruvilla, Philip T. Physical Med & Rehab University Physical Medicine & Rehab 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Labi, Maria L. Physical Med & Rehab Maria L Labi 2121 Main St Ste 210 Buffalo NY 14214 Erie 7168321000

Labi, Maria L. Physical Med & Rehab Maria L Labi 2950 Elmwood Ave Kenmore NY 14217 Erie 7168321000

Labi, Maria L. Physical Med & Rehab Rehabilitation Physician Services of Erie County PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Labi, Maria L. Physical Med & Rehab Grider Medical Services PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Laraiso, Ralph G. Physical Med & Rehab Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Laraiso, Ralph G. Physical Med & Rehab Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Lawrence, James Physical Med & Rehab Lawrence, James 564 Niagara St Buffalo NY 14201 Erie 7163620980

Livecchi, Mark A. Physical Med & Rehab Rehabilitation Physician Services of Erie County PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Livecchi, Mark A. Physical Med & Rehab Grider Medical Services PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Love, Elizabeth Physical Med & Rehab Elder Medical Services PC 132 Cayuga Rd Ste 1C Cheektowaga NY 14225 Erie 7162049711

Love, Elizabeth Physical Med & Rehab Elder Medical Services PC 200 7th St Buffalo NY 14201 Erie 7168472500

Love, Elizabeth Physical Med & Rehab IPC Hospitalist Services of New York, PC 50 Lakefront Blvd Ste 130 Buffalo NY 14202 Erie 7168498750

Malik, Chetan Physical Med & Rehab Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Malik, Chetan Physical Med & Rehab Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Williamsville NY 14221 Erie 7168757399

Malik, Chetan Physical Med & Rehab Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Matteliano, Andrew C. Physical Med & Rehab Matteliano, Andrew 235 North St Buffalo NY 14201 Erie 7168820726

McAdam, Frederick B. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 400 Orchard Park NY 14127 Erie 7166260093

McAdam, Frederick B. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

McAdam, Frederick B. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

McAdam, Frederick B. Physical Med & Rehab Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Amherst NY 14226 Erie 7166260093

McAdam, Frederick B. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

McAdam, Frederick B. Physical Med & Rehab Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Miller, S David Physical Med & Rehab Miller, S David 5820 Main St Ste 200 Williamsville NY 14221 Erie 7166337544

Miller, S David Physical Med & Rehab S David Miller MD 5820 Main St Ste 200 Williamsville NY 14221 Erie 7166337544

Miller, S David Physical Med & Rehab S David Miller MD 240 Redtail Dr Orchard Park NY 14127 Erie 7166891901

Narayanan, Sobhana Physical Med & Rehab Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Narayanan, Sobhana Physical Med & Rehab University Physical Medicine & Rehab 100 High St Buffalo NY 14203 Erie 7168597177

Narayanan, Sobhana Physical Med & Rehab Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Qazi, Tahir M. Physical Med & Rehab EMG Spine & Sports Medicine LLC 3884 Broadway Cheektowaga NY 14227 Erie 7166819000

Romanowski, Cindy R. Physical Med & Rehab Repicci and Romanowski MD Inc 4510 Main St Amherst NY 14226 Erie 7168390632

Salcedo, Daniel M. Physical Med & Rehab Salcedo, Daniel 3775 Southwestern Blvd Ste B Orchard Park NY 14127 Erie 7166671980

Page 107 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Salcedo, Daniel M. Physical Med & Rehab Salcedo, Daniel 6245 Sheridan Dr Ste 116 Williamsville NY 14221 Erie 7165051500

Salcedo, Daniel M. Physical Med & Rehab Salcedo, Daniel 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Salcedo, Daniel M. Physical Med & Rehab Salcedo, Daniel 462 Grider St Rehab G 200 Buffalo NY 14215 Erie 7168984995

Salcedo, Daniel M. Physical Med & Rehab Salcedo, Daniel M. 6245 Sheridan Dr Ste 116 Williamsville NY 14221 Erie 7165051500

Schleifer-Schneggenburger, Jill Physical Med & Rehab Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Shieh, Jong Chaur Physical Med & Rehab VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Siddiqui, Jafar W. Physical Med & Rehab New York Anesthesiology Medical Specialties PC 6970 Erie Rd Ste B Derby NY 14047 Erie 7165803380

Siddiqui, Jafar W. Physical Med & Rehab New York Anesthesiology Medical Specialties PC 180 Park Club Ln Ste 250 Williamsville NY 14221 Erie 7165803380

Siddiqui, Jafar W. Physical Med & Rehab New York Anesthesiology Medical Specialties PC 180 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7165803380

Vullo, Valerie J. Physical Med & Rehab Valerie Vullo 8750 Transit Rd East Amherst NY 14051 Erie 7166880075

Wang, Gary G. Physical Med & Rehab Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Wang, Gary G. Physical Med & Rehab Academic Buffalonias in Physical Med & Rehab PC 2121 Main St Ste 210 Buffalo NY 14214 Erie 7168321000

Wang, Gary G. Physical Med & Rehab University Physical Medicine & Rehab 462 Grider St Buffalo NY 14215 Erie 7168983000

Welch, Mary R. Physical Med & Rehab Rehabilitation Physician Services of Erie County PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Welch, Mary R. Physical Med & Rehab Grider Medical Services PLLC 426 Grider St Buffalo NY 14215 Erie 7162044500

Welch, Mary R. Physical Med & Rehab Welch, Mary 462 Grider St Dept of Physical Med and Rehabiliation Buffalo NY 14215 Erie 7168985920

Welch, Mary R. Physical Med & Rehab Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7168983000

Zhan, Su Physical Med & Rehab WNY Rehabilitation Medicine and Pain Management LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168214450

Zhan, Su Physical Med & Rehab WNY Rehabilitation Medicine and Pain Management LLC 550 Orchard Park Rd Bldg C West Seneca NY 14224 Erie 7165585133

Zhan, Su Physical Med & Rehab WNY Rehabilitation Medicine and Pain Management LLC 462 Grider St Buffalo NY 14215 Erie 7168984743

Zhan, Su Physical Med & Rehab 462 Grider St Buffalo NY 14215 Erie 7168984743

Zhan, Su Physical Med & Rehab WNY Rehabilitation Medicine and Pain Management LLC 550 Orchard Park Rd Bldg B West Seneca NY 14224 Erie 7166772700

Zhan, Su Physical Med & Rehab 565 Abbott Rd Buffalo NY 14220 Erie 7168984743

Zhou, Xin Physical Med & Rehab Amerina Physical Medicine & Rehabilitation PLLC 8770 Transit Rd Ste 2 East Amherst NY 14051 Erie 7166897546

Abbott, Holly Physical Therapy Advanced Care Physical Therapy 6460 Main St Fl 2 Williamsville NY 14221 Erie 7162822888

Abel, Timothy J. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Abel, Timothy J. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Abel, Timothy J. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Ackerman, Elizabeth Physical Therapy Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Adesso, Michael A. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043240

Adesso, Michael A. Physical Therapy University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Adesso, Michael A. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Adesso, Michael A. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7169065908

Alessi, Matthew C. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Alexander, Aimee C. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Alexander, Aimee C. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Alexander, Aimee C. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Anibaldi, Jessica L. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Anibaldi, Jessica L. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Aquino, Joseph A. Physical Therapy Keith L Stube Md Pr Knee Center Of 3712 Southwestern Blvd Orchard Park NY 14127 Erie 7168395858

Aquino, Joseph A. Physical Therapy Keith L Stube Md Pr Knee Center Of 180 Park Club Ln Ste 225 Williamsville NY 14221 Erie 7168395858

Bachman, Samuel R. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Bainbridge, Susan L. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Barbasch, Amy T. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Barbasch, Amy T. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Barbasch, Amy T. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Barbasch, Amy T. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Barbasch, Amy T. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Barbasch, Amy T. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Barbolini, Ruddi E. Physical Therapy Barbolini, Ruddi 4575 Main St Ste 2 Amherst NY 14226 Erie 7168392881

Baumgarden, Joseph Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Bennett, Susan E. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166903051

Bennett, Susan E. Physical Therapy University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Buffalo NY 14226 Erie 7162181000

Bennett, Susan E. Physical Therapy Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Bergmann, Jordan M. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7166621435

Bergmann, Jordan M. Physical Therapy University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Bergmann, Jordan M. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Bilski, Lauren Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Bilson, Lindsay S. Physical Therapy Buffalo Rehab Group P T 8750 Transit Rd Ste 120 East Amherst NY 14051 Erie 7165681251

Blanford, Gregory W. Physical Therapy Buffalo Rehab Group P T 4855 Camp Rd Ste 200 Hamburg NY 14075 Erie 7166461100

Blaszak, Stephanie L. Physical Therapy Advanced care physical therapy of wny pc 12845 Broadway Alden NY 14004 Erie 7169025068

Blaszak, Stephanie L. Physical Therapy Advanced care physical therapy of wny pc 3040 Amsdell Rd Ste 207B Hamburg NY 14075 Erie 7166490444

Bogulski, Jennifer A. Physical Therapy Buffalo Rehab Group P T 4780 SouthPark Ave Hamburg NY 14075 Erie 7166469100

Bosela, David M. Physical Therapy East Aurora Family Physical Therapy, PC 19 Olean St East Aurora NY 14052 Erie 7166523127

Bowers, Jason S. Physical Therapy University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Bowers, Jason S. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Page 108 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Bowers, Jason S. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043200

Bowers, Jason S. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7169065908

Brant, Nathan Physical Therapy Ascend Therapy Group PC 6929 Erie Rd Derby NY 14047 Erie 7169474422

Brant, Nathan Physical Therapy Ascend Therapy Group PC 1110 Abbott Rd Buffalo NY 14220 Erie 7168211339

Brant, Nathan Physical Therapy Ascend Therapy Group PC 1150 Youngs Rd Ste 210 Williamsville NY 14221 Erie 7166899201

Briggs, Lorraine E. Physical Therapy Weston Paxxon PT OT & SLP PLLC 245 Bassett Rd Williamsville NY 14221 Erie 7166360715

Briggs, Lorraine E. Physical Therapy PRN Physical & Occupational Therapy Network PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Briggs, Lorraine E. Physical Therapy PRN Physical & Occupational Therapy Network PLLC 6363 Transit Rd Ste 201 East Amherst NY 14051 Erie 7166885709

Briggs, Lorraine E. Physical Therapy Weston Paxxon PT OT & SLP PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Brogan, Michael S. Physical Therapy Daemen College Physical Therapy, Inc 2355 Union Rd Ste 100 Buffalo NY 14227 Erie 7166718073

Bromley, Lacey E. Physical Therapy University at Buffalo Neurosurgery Inc 3980A Sheridan Dr Buffalo NY 14226 Erie 7162181000

Bromley, Lacey E. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166902051

Bromley, Lacey E. Physical Therapy Susan E Bennett & Associates, PC 3980 Sheridan Dr Buffalo NY 14226 Erie 7166902051

Brown, Daniel P. Physical Therapy Buffalo Physical Therapy & Sports Rehab 192 Park Club Ln Ste 110 Williamsville NY 14221 Erie 7166329200

Brown, Donald J. Physical Therapy Genesee Valley Group Health Association Lifetime Health 692 Millersport Hwy Amherst NY 14226 Erie 7168399529

Brown, Donald J. Physical Therapy Buffalo Physical Therapy & Sports Rehab 192 Park Club Ln Ste 110 Williamsville NY 14221 Erie 7166329200

Brown, Walter C. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Brown, Walter C. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Brown, Walter C. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Brown, Walter C. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Brown, Walter C. Physical Therapy Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Amherst NY 14226 Erie 7166260093

Brzykcy, David J. Physical Therapy Brzykcy, David 2258 Seneca St Buffalo NY 14210 Erie 7168672138

Burns, Brian P. Physical Therapy Family Physical Therapy & Fitness PLLC 1515 Kensington Ave Buffalo NY 14215 Erie 7164401118

Bushby, Chelsea E. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Bushby, Chelsea E. Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

Carducci, Alyssa C. Physical Therapy West Seneca Physical Therapy 560 Center Rd West Seneca NY 14224 Erie 7166741509

Carpenter, Kimberlee M. Physical Therapy Swiatek Physical Therapy PLLC 4498 Main St Ste 24 Amherst NY 14226 Erie 7168391550

Carter, Joanne M. Physical Therapy Carter, Joanne M. 8835 Sheridan Dr Williamsville NY 14221 Erie 7163089020

Cassata, Joseph K. Physical Therapy Buffalo Physical Therapy & Sports Rehab 192 Park Club Ln Ste 110 Williamsville NY 14221 Erie 7166329200

Castellas, Nadya M. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Castellas, Nadya M. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Castellas, Nadya M. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Castellas, Nadya M. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Certo, Russell A. Physical Therapy Grand Island Physical Therapy 1491 Kenmore Ave Kenmore NY 14217 Erie 7168711100

Certo, Russell A. Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Christie, Kathleen A. Physical Therapy Sports Rehab Physical Therapy, PLLC 27 Franklin St Springville NY 14141 Erie 7165922483

Christie, Kathleen A. Physical Therapy Sports Rehab Physical Therapy, PLLC 4545 Transit Rd Ste 640 Williamsville NY 14221 Erie 7166398212

Christie, Kathleen A. Physical Therapy Sports Rehab Physical Therapy, PLLC 5102 Transit Rd Depew NY 14043 Erie 7166839310

Chwojdak, Jillian M. Physical Therapy Buffalo Rehab Group P T 4855 Camp Rd Ste 200 Hamburg NY 14075 Erie 7166461100

Cimorelli, Julie L. Physical Therapy Hamburg Physical Therapy Pc 230 Buffalo St Hamburg NY 14075 Erie 7166485211

Clemens, Matthew B. Physical Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Costello, Maria E. Physical Therapy Aspire of WNY Inc 4635 Union Rd Cheektowaga NY 14225 Erie 7165055700

Cotto, Valerie Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Cox, Brian M. Physical Therapy Cox Chiropractic and Therapy PC 4164 N Buffalo Rd Orchard Park NY 14127 Erie 7168262766

Cummings, Julie T. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

Curl, Shelley H. Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Dauber, Jodi B. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

Davignon, Deborah M. Physical Therapy Autumn View Health Care Facility LLC S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Davignon, Deborah M. Physical Therapy Harris Hill Nursing Facility 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

De Luca, Brian J. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043200

De Luca, Brian J. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7169065908

De Luca, Brian J. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

De Luca, Brian J. Physical Therapy University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Desotelle, Ann Physical Therapy Northtown Physical Therapy 5225 Sheridan Dr Williamsville NY 14221 Erie 7166312626

Dinse, Scott A. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Dinse, Scott A. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall 3434 Main St Buffalo NY 14214 Erie 7168292070

Dinse, Scott A. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7166621435

Dinse, Scott A. Physical Therapy University Orthopaedics Services Inc 412 Lake St Orchard Park NY 14127 Erie 7167519341

Dinse, Scott A. Physical Therapy University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Doll, Kira M. Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Doll, Kira M. Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Buffalo NY 14221 Erie 7166313555

Donegan, Danae M. Physical Therapy Step By Step Physical Therapy Pc 56 Main St Akron NY 14001 Erie 7165421135

Donlan, Danielle M. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Donlan, Danielle M. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Donner, David C. Physical Therapy Buffalo Rehab Group P T 4855 Camp Rd Ste 200 Hamburg NY 14075 Erie 7166461100

Donner, David C. Physical Therapy Buffalo Rehab Group P T 4855 Camp Rd Hamburg NY 14075 Erie 7166461100

Page 109 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Doyle, Tracy M. Physical Therapy Doyle, Tracy 4184 Seneca St Ste 211 West Seneca NY 14224 Erie 7166772027

Dressel, Erin J. Physical Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Duchscherer, Brian N. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Duchscherer, Brian N. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7166621435

Duchscherer, Brian N. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Dukhon, Margarita Physical Therapy The Resource Center 101 Oak St Buffalo NY 14203 Erie 7168564204

Eagan, Teresa M. Physical Therapy SPortsFocus Physical Therapy 3940 CALIFORNIA RD Buffalo NY 14217 Erie 7166622922

Eagan, Teresa M. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Edelman, Robbert Physical Therapy Western New York Physical And Occupational Therapy 12395 Olean Rd Chaffee NY 14030 Erie 7164965550

Enser, Amy E. Physical Therapy Buffalo Rehab Group P T 350 Greenhaven Ter Tonawanda NY 14150 Erie 7162130772

Erickson, Robert M. Physical Therapy Hamburg Physical Therapy Pc 230 Buffalo St Hamburg NY 14075 Erie 7166485211

Falker, Christina Physical Therapy Step By Step Physical Therapy Pc 56 Main St Akron NY 14001 Erie 7165421135

Fattey, Eric J. Physical Therapy Buffalo Rehab Group P T 4780 S Park Ave Hamburg NY 14075 Erie 7166469100

Favaro, Laura M. Physical Therapy Swiatek Physical Therapy PLLC 4498 Main St Ste 24 Amherst NY 14226 Erie 7168391550

Field, Adam Physical Therapy Glover Physical Therapy PLLC 1829 Maple Rd Ste 110 Williamsville NY 14221 Erie 7166340940

Field, Adam Physical Therapy Glover Physical Therapy PLLC 3620 Harlem Rd Ste 2 Cheektowaga NY 14215 Erie 7164469500

Fisher, Josette A. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Foigelman Holland, Dorothy E. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Buffalo NY 14217 Erie 7168739154

Foigelman, Gerald M. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Ford, Gregory S. Physical Therapy Ford, Gregory S. 646 N French Rd Ste 2 Amherst NY 14228 Erie 7166258077

Fuest, Lauren A. Physical Therapy Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Garrett, Tara S. Physical Therapy Vivian L Lindfield MD PC 3915 Sheridan Dr Amherst NY 14226 Erie 7166327465

Gedeon, Paula M. Physical Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 3940 California Rd Orchard Park NY 14127 Erie 7166315224

Gedeon, Paula M. Physical Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 4949 Harlem Rd Amherst NY 14226 Erie 7166315224

Gedeon, Paula M. Physical Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 5144 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7166315224

Gibson, Sarah L. Physical Therapy Swiatek Physical Therapy PLLC 4498 Main St Ste 24 Amherst NY 14226 Erie 7168391550

Gibson, Sarah L. Physical Therapy Rose Physical Therapy PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7166970106

Gigante, Sarah D. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Gigante, Sarah D. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163818214

Glover, Brian K. Physical Therapy Glover Physical Therapy PLLC 3620 Harlem Rd Ste 2 Cheektowaga NY 14215 Erie 7164469500

Glover, Brian K. Physical Therapy Glover Physical Therapy PLLC 1829 Maple Rd Ste 110 Williamsville NY 14221 Erie 7166340940

Gmerek, Charlene A. Physical Therapy Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Golden, Michael Physical Therapy Buffalo Rehab Group P T 350 Greenhaven Ter Tonawanda NY 14150 Erie 7162130772

Goldwater, Trisha M. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Goldwater, Trisha M. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Gonser, Steven R. Physical Therapy Buffalo Rehab Group P T 150 Tech Dr Buffalo NY 14221 Erie 7162768641

Goode, Anthony T. Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 240 Red Tail Dr Sts 3 and 4 Orchard Park NY 14127 Erie 7166749600

Goode, Anthony T. Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 4535 Southwestern Blvd Sts 805 and 806 Hamburg NY 14075 Erie 7166488700

Gorny, Diane M. Physical Therapy Aspire of WNY Inc 2356 N Forest Rd Getzville NY 14068 Erie 7165055883

Graham, Melissa J. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Graham, Melissa J. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Gulick, Donna A. Physical Therapy Donna A Gulick and Peter H Young 3970 Harlem Rd Snyder NY 14226 Erie 7168393705

Gurgol, Paul W. Physical Therapy Sports Rehab Physical Therapy, PLLC 27 Franklin St Springville NY 14141 Erie 7165922483

Gurgol, Paul W. Physical Therapy Sports Rehab Physical Therapy, PLLC 4545 Transdit Rd Buffalo NY 14221 Erie 7166398212

Gurgol, Paul W. Physical Therapy Sports Rehab Physical Therapy, PLLC 5102 Transit Rd Depew NY 14043 Erie 7166839310

Hall, Teresa A. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Hall, Teresa A. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Hall, Teresa A. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Hall, Teresa A. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Hall, Teresa A. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Hall, Teresa A. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Hamilton, Brenda J. Physical Therapy Donna A Gulick and Peter H Young 3970 Harlem Rd Snyder NY 14226 Erie 7168393705

Hamilton, Brenda J. Physical Therapy Donna A Gulick and Peter H Young 8637 Main St Williamsville NY 14221 Erie 7166341578

Hammel, Raymond J. Physical Therapy Buffalo Rehab Group P T 350 Greenhaven Ter Tonawanda NY 14150 Erie 7162130772

Harb, George F. Physical Therapy George Harb MSPT Center for Chronic Pain 3085 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7166745138

Haynes, Debra A. Physical Therapy Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Held, Sharon L. Physical Therapy SPortsFocus Physical Therapy 3940 CALIFORNIA RD Orchard Park NY 14127 Erie 7166622922

Held, Sharon L. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Herman, Eric M. Physical Therapy Buffalo Rehab Group P T 4855 Camp Rd Ste 200 Hamburg NY 14075 Erie 7166461100

Herrmann, Francis J. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7168292070

Herrmann, Francis J. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Herrmann, Francis J. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7166621435

Hodas, Sylbie Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Hodges, Delante K. Physical Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168545700

Hoestermann, Allison S. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Hoestermann, Allison S. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Page 110 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Hoestermann, Allison S. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Hoestermann, Allison S. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Hoestermann, Allison S. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Hoestermann, Allison S. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Horrigan, Bartholomew J. Physical Therapy Ascend Therapy Group PC 6929 Erie Rd Derby NY 14047 Erie 7169474422

Horrigan, Bartholomew J. Physical Therapy Ascend Therapy Group PC 1150 Youngs Rd Ste 210 Williamsville NY 14221 Erie 7166899201

Horrigan, Bartholomew J. Physical Therapy Ascend Therapy Group PC 1110 Abbott Rd Buffalo NY 14220 Erie 7168211339

Horrigan, Dennis L. Physical Therapy West Seneca Physical Therapy 560 Center Rd West Seneca NY 14224 Erie 7166741509

Howard, Kathleen M. Physical Therapy Howard Physical Therapy PLLC 4721 Transit Rd Depew NY 14043 Erie 7166561880

Howard, Mark E. Physical Therapy Howard Physical Therapy PLLC 4721 Transit Rd Depew NY 14043 Erie 7166561880

Howard, Mark E. Physical Therapy Southtowns Physical Therapy 100 Union Rd West Seneca NY 14224 Erie 7166754444

Howard, Mark E. Physical Therapy Southtowns Physical Therapy 4845 Transit Rd Lancaster NY 14043 Erie 7166561880

Huffman, Janet L. Physical Therapy Southtowns Physical Therapy 4845 Transit Rd Lancaster NY 14043 Erie 7166561880

Huffman, Janet L. Physical Therapy Southtowns Physical Therapy 3040 Amsdell Rd Hamburg NY 14075 Erie 7166490444

Huffman, Janet L. Physical Therapy Southtowns Physical Therapy 100 Union Rd West Seneca NY 14224 Erie 7166754444

Hussain, Jamal T. Physical Therapy Hussain, Jamal 5445 Transit Rd Buffalo NY 14221 Erie 7165803535

Iraci III, Sammy F. Physical Therapy Family Physical Therapy & Fitness PLLC 6245 Sheridan Dr Ste 112 Williamsville NY 14221 Erie 7165650818

Iraci III, Sammy F. Physical Therapy Pain Rehab of WNY PLLC 1515 Kensington Ave Buffalo NY 14215 Erie 7164465900

Iraci III, Sammy F. Physical Therapy Family Physical Therapy & Fitness PLLC 1515 Kensington Ave Buffalo NY 14215 Erie 7164401118

Izkhakov, Shoshana Physical Therapy PRN Physical & Occupational Therapy Network PLLC 6363 Transit Rd East Amherst NY 14051 Erie 7166885709

Izkhakov, Shoshana Physical Therapy Weston Paxxon PT OT & SLP PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Jachimowicz, Robert Physical Therapy East Amherst Physical Therapy Pc 3385 Orchard Park Rd Orchard Park NY 14127 Erie 7166746859

Jakson, Michele M. Physical Therapy Body Dynamics Physical Therapy & Wellnes 9750 Transit Rd East Amherst NY 14051 Erie 7163488734

Jakson, Michele M. Physical Therapy Kenneth R Kurtz Pt 8705 Sheridan Dr Williamsville NY 14221 Erie 7166311212

Jarnot, Tanya M. Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Jenk, Drew T. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Jenk, Drew T. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Jenk, Drew T. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Johnson, Chelsea E. Physical Therapy Greater Buffalo Physical Ther 3950 E Robinson Rd Ste 201 Amherst NY 14228 Erie 7166363950

Johnston, Jeanne M. Physical Therapy PRN Physical & Occupational Therapy Network PLLC 6363 Transit Rd East Amherst NY 14051 Erie 7166885709

Joshi, Anita S. Physical Therapy All Care Physical Therapy Servi 3101 Main St Buffalo NY 14214 Erie 7168345635

Joshi, Anita S. Physical Therapy All Care Physical Therapy Servi 564 Niagara St Buffalo NY 14201 Erie 7168345635

Joshi, Anita S. Physical Therapy All Care Physical Therapy Servi 3719 Union Rd Ste 122 Cheektowaga NY 14225 Erie 7166846640

Kaczmarek, Phillip J. Physical Therapy Usrh DC & PT PC 2448 Union Rd Cheektowaga NY 14227 Erie 7166560200

Kaiser, Seth A. Physical Therapy Kaiser, Seth 121 Elm St East Aurora NY 14052 Erie 7166521803

Kaminska, Michael Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Kaminska, Michael Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Keller, Daniel R. Physical Therapy Rose Physical Therapy PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7162048734

Kempke, Michael E. Physical Therapy University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Kempke, Michael E. Physical Therapy University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043200

Kempke, Michael E. Physical Therapy University Orthopaedics Services Inc 4 Centre Dr Ste G Orchard Park NY 14127 Erie 7169065908

Kempke, Michael E. Physical Therapy University Orthopaedics Services Inc 160 Farber Hall 3434 Main St Buffalo NY 14214 Erie 7168292070

Kidder, Heather M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Kidder, Heather M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Kidder, Heather M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Kiggins, Catherine N. Physical Therapy Susan E Bennett & Associates, PC 3980 Sheridan Dr Amherst NY 14226 Erie 7166902051

Kiggins, Catherine N. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166902051

Kilburn, Matthew R. Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Kirchmyer, Jeffrey Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 4535 Southwestern Blvd Sts 805 and 806 Hamburg NY 14075 Erie 7166488700

Kirchmyer, Jeffrey Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 240 Red Tail Dr Sts 3 and 4 Orchard Park NY 14127 Erie 7166749600

Knoph, Lindsey A. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162506500

Kociszewski, Mary B. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Kociszewski, Mary B. Physical Therapy The Waters of Aurara Park 292 Main St East Aurora NY 14052 Erie 7166521560

Koenig, Christopher Physical Therapy Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Kordylewski, Robert Physical Therapy Harris Hill Nursing Facility 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Kordylewski, Robert Physical Therapy Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7166688100

Korosi, Rebecca L. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Korosi, Rebecca L. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Korosi, Rebecca L. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Korosi, Rebecca L. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Korosi, Rebecca L. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Korosi, Rebecca L. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Koshinski, Robert S. Physical Therapy Buffalo Rehab Group P T 150 Tech Dr Williamsville NY 14221 Erie 7162768641

Kosinski, Jillian A. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Koslosky, Martin R. Physical Therapy Amherst Orthopedic Physical Therapy PC 2625 Delaware Ave Buffalo NY 14216 Erie 7168742759

Kowalski, Thomas M. Physical Therapy West Seneca Physical Therapy 560 Center Rd West Seneca NY 14224 Erie 7166741509

Page 111 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kowalski, Thomas M. Physical Therapy Advanced care physical therapy of wny pc 3040 Amsdell Rd Hamburg NY 14075 Erie 7166490444

Kowalski, Thomas M. Physical Therapy Advanced care physical therapy of wny pc 12845 Broadway St Alden NY 14004 Erie 7169025068

Kraus, Thomas J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Kraus, Thomas J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Kraus, Thomas J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Kraus, Thomas J. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Krolewski, James Physical Therapy Keith L Stube Md Pr Knee Center Of 180 Park Club Ln Ste 225 Williamsville NY 14221 Erie 7168395858

Krug, Kenneth J. Physical Therapy Daemen College Physical Therapy, Inc 2355 Union Rd Ste 100 Cheektowaga NY 14227 Erie 7166718073

Kulpit, Matthew R. Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Kulpit, Matthew R. Physical Therapy Grand Island Physical Therapy 1491 Sheridan Dr Kenmore NY 14217 Erie 7168711100

Kurtz, Kenneth R. Physical Therapy Kenneth R Kurtz Pt 8705 Sheridan Dr Williamsville NY 14221 Erie 7166311212

Lachowski, David J. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Lambert, Martin C. Physical Therapy Buffalo Rehab Group P T 4780 SouthPark Ave Hamburg NY 14075 Erie 7166469100

Lambrecht, Jennifer A. Physical Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Buffalo NY 14203 Erie 7168403380

LeBlanc, Katherine E. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

LeBlanc, Katherine E. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Lewis, Lisa M. Physical Therapy Pinnacle Orthopedic and Spine Specialists 700 Michigan Ave Ste 130 Buffalo NY 14203 Erie 7168403380

Lipford Kraus, Jacqueline E. Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Long, Allyson M. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163818214

Long, Allyson M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Lord, John A. Physical Therapy Southtowns Physical Therapy 3040 Amsdell Rd Hamburg NY 14075 Erie 7166490444

Lord, John A. Physical Therapy Southtowns Physical Therapy 100 Union Rd West Seneca NY 14224 Erie 7166754444

Lord, John A. Physical Therapy Southtowns Physical Therapy 4845 Transit Rd Lancaster NY 14043 Erie 7166561880

Lowman Delles, Donna M. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166902051

Mandell, Jolie A. Physical Therapy Michael D Calabrese MD PC 656 Elmwood Ave Buffalo NY 14222 Erie 7168830515

Mandell, Jolie A. Physical Therapy Body Werks Physical Therapy PLLC 8746 Erie Rd Ste A Angola NY 14006 Erie 7165494999

Manzella, David Physical Therapy SPortsFocus Physical Therapy 3940 CALIFORNIA RD Orchard Park NY 14127 Erie 7166622922

Manzella, David Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Martin, Lisa V. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Martin, Lisa V. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Martin, Lisa V. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Martin, Lisa V. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Martin, Lisa V. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Marzullo, Sylvia Physical Therapy Amherst Orthopedic Physical Therapy PC 2625 Delaware Ave Buffalo NY 14216 Erie 7168742759

Maskulinski, Tiffany A. Physical Therapy Buffalo Rehab Group P T 2100 UNION RD West Seneca NY 14224 Erie 7166568600

Maskulinski, Tiffany A. Physical Therapy Buffalo Rehab Group P T 8750 Transit Rd Ste 120 East Amherst NY 14051 Erie 7165681251

Massaro, Michael P. Physical Therapy Buffalo Spine & Sports Medicine PC 425 Meyer Rd Buffalo NY 14224 Erie 7166923302

Massaro, Michael P. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Massaro, Michael P. Physical Therapy Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Amherst NY 14226 Erie 7166923302

Massaro, Michael P. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Massaro, Michael P. Physical Therapy Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 500 Orchard Park NY 14127 Erie 7166923302

Massaro, Michael P. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Massaro, Michael P. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Mauro, Erin M. Physical Therapy Buffalo Rehab Group P T 4780 S Park Ave Hamburg NY 14075 Erie 7166469100

Maving, Thomas D. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Maving, Thomas D. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Maving, Thomas D. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Maving, Thomas D. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Maving, Thomas D. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Maving, Thomas D. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Mazur, Rachel M. Physical Therapy Western New York Physical And Occupational Therapy 2700 N Forest Rd Ste 101 Getzville NY 14068 Erie 7166393311

McGarrity, Sean K. Physical Therapy Angola Physical Therapy PC 8505 Erie Rd Angola NY 14006 Erie 7165491099

McGary, Thomas J. Physical Therapy Paul D Whissel 5629 Main St Studio 203 Williamsville NY 14221 Erie 7163596316

McKenzie, Renee A. Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 4535 Southwestern Blvd Sts 805 and 806 Hamburg NY 14075 Erie 7166488700

McKenzie, Renee A. Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 240 Red Tail Dr Sts 3 and 4 Orchard Park NY 14127 Erie 7166749600

McKeown, Molly A. Physical Therapy Western New York Physical And Occupational Therapy 12399 Olean Rd Chaffee NY 14030 Erie 7164965550

McPherson, Jacob I. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166902051

Meyer, John T. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Meyers, Taylor L. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

Miller, Cindy L. Physical Therapy Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301212

Miller, Colleen A. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Miller, Colleen A. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Miller, Colleen A. Physical Therapy Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 500 Orchard Park NY 14127 Erie 7166774484

Miller, Colleen A. Physical Therapy Buffalo Spine & Sports Medicine PC 425 Meyer Rd West Seneca NY 14224 Erie 7166260093

Miller, Colleen A. Physical Therapy Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Amherst NY 14226 Erie 7166260093

Miller, Colleen A. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Page 112 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Miller, Colleen A. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Monahan, Gena M. Physical Therapy Harris Hill Nursing Facility 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Monahan, Gena M. Physical Therapy Harris Hill Nursing Facility 57 Fifth Ave Buffalo NY 14221 Erie 7166325083

Morgan, Brett A. Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Morgan, Brett A. Physical Therapy Advanced care physical therapy of wny pc 12845 Broadway Alden NY 14004 Erie 7169025068

Morgan, Brett A. Physical Therapy Advanced care physical therapy of wny pc 3040 Amsdell Rd Suite 2078 Hamburg NY 14075 Erie 7166490444

Mullane, Felicia H. Physical Therapy Mullane, Felicia 13776 Centerline Rd South Wales NY 14139 Erie 7166556131

Munch, Kenneth A. Physical Therapy Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Murray, Brian T. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

Muscatello, Richard R. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Muscatello, Richard R. Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

Musilli, Chris J. Physical Therapy Grand Island Physical Therapy 1491 Sheridan Dr Kenmore NY 14217 Erie 7168711101

Musilli, Chris J. Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Naab, Timothy P. Physical Therapy Kenneth R Kurtz Pt 8705 Sheridan Dr Williamsville NY 14221 Erie 7166311212

Nentarz, Christopher J. Physical Therapy Buffalo Spine & Sports Medicine PC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Nentarz, Christopher J. Physical Therapy Buffalo Spine & Sports Medicine PC 2075 Sheridan Dr Kenmore NY 14223 Erie 7166260093

Nentarz, Christopher J. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Nentarz, Christopher J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 142216800 Erie 7166260093

Nentarz, Christopher J. Physical Therapy Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 500 Orchard Park NY 14127 Erie 7166774483

Nentarz, Christopher J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Nentarz, Christopher J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 770 Wehrle Dr Cheektowaga NY 14225 Erie 7166260093

Nentarz, Christopher J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Niezgoda, Molly M. Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Norman, Ashley M. Physical Therapy Angola Physical Therapy PC 8505 Erie Rd Angola NY 14006 Erie 7165491099

Norton, Cynthia J. Physical Therapy East Aurora Family Physical Therapy, PC 19 Olean St East Aurora NY 14052 Erie 7166523127

Nuwer, Lisa A. Physical Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 3940 California Rd Orchard Park NY 14127 Erie 7166315224

Nuwer, Lisa A. Physical Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 4949 Harlem Rd Amherst NY 14226 Erie 7166315224

Nuwer, Lisa A. Physical Therapy Hand & Rehabilitation Specialists OT PT SLP PLLC 5144 Sheridan Dr Ste 2 Williamsville NY 14221 Erie 7166315224

O Connor, Patrick M. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

O Keefe, Paul A. Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

O Keefe, Paul A. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

O Keefe, Paul A. Physical Therapy SPortsFocus Physical Therapy 3940 California Road Orchard Park NY 14127 Erie 7166622922

Odachowski, Cynthia M. Physical Therapy East Aurora Family Physical Therapy, PC 19 Olean St East Aurora NY 14052 Erie 7166523127

Olszowka, Ann C. Physical Therapy Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Olszowka, Ann C. Physical Therapy Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Oppenheimer, Philip J. Physical Therapy Buffalo Spine & Sports Medicine PC 200 Sterling Dr Ste 500 Orchard Park NY 14127 Erie 7162620093

Oppenheimer, Philip J. Physical Therapy Buffalo Spine & Sports Medicine PC 425 Meyer Rd Buffalo NY 14224 Erie 7162620093

Oppenheimer, Philip J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 4685 Transit Rd Williamsville NY 14221 Erie 7166260093

Oppenheimer, Philip J. Physical Therapy Buffalo Spine & Sports Medicine PC 4949 Harlem Rd Ste 300 Buffalo NY 14226 Erie 7162620093

Oppenheimer, Philip J. Physical Therapy Buffalo Spine & Sports Medicine PC 100 College Pkwy Ste 100 Buffalo NY 14221 Erie 7166260093

Oppenheimer, Philip J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Oppenheimer, Philip J. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Orama, Maurya Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Orama, Maurya Physical Therapy Grand Island Physical Therapy 1491 Sheridan Dr Kenmore NY 14217 Erie 7168711100

Orta III, Jose Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Orta III, Jose Physical Therapy Advanced care physical therapy of wny pc 3040 Amsdell Rd Hamburg NY 14075 Erie 7166490444

Orta III, Jose Physical Therapy Advanced care physical therapy of wny pc 12845 Broadway St Alden NY 14004 Erie 7166490444

Owcarz, Matthew W. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166902051

Owczarczak, Michelle L. Physical Therapy Buffalo Medical Group 425 Essjay Rd Ste 170 Williamsville NY 14221 Erie 7166301020

Page, Brian J. Physical Therapy Kaleida Health 3980 Sheridan Dr Buffalo NY 14226 Erie 7169619900

Passarelli, Lisa M. Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Phelan, Jamie L. Physical Therapy Weston Paxxon PT OT & SLP PLLC 6055 Armor Duells Rd Orchard Park NY 14127 Erie 7166625544

Phelan, Jamie L. Physical Therapy PRN Physical & Occupational Therapy Network PLLC 3030 Clinton St Buffalo NY 14224 Erie 7168240104

Phelan, Jamie L. Physical Therapy PRN Physical & Occupational Therapy Network PLLC 6055 Armor Duells Rd Orchard Park NY 14127 Erie 7166625909

Pitarresi, John M. Physical Therapy John Pitarresis South Shore PT PC 6091 S Park Ave Hamburg NY 14075 Erie 7166495789

Pleban, Elizabeth H. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Pleban, Elizabeth H. Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

Podraza, Jeffery T. Physical Therapy Kenneth R Kurtz Pt 8705 Sheridan Dr Williamsville NY 14221 Erie 7166311212

Pokorski, Alanna Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Pokorski, Alanna Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Pokorski, Alanna Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Pokorski, Alanna Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Pokorski, Alanna Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Pokorski, Alanna Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Pordum II, Frederick F. Physical Therapy Daemen College Physical Therapy, Inc 2355 Union Rd Ste 100 Cheektowaga NY 14227 Erie 7166718073

Porebski, Brian T. Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Page 113 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Prince, Sripriya M. Physical Therapy University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Privitera, Peter J. Physical Therapy Step By Step Physical Therapy Pc 56 Main St Akron NY 14001 Erie 7165421135

Przybyla, Jesse J. Physical Therapy VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Pugliese, Dianna A. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Pugliese, Dianna A. Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

Pulvino, Allison Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Pulvino, Allison Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Pulvino, Allison Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Rabin, Marie B. Physical Therapy Weston Paxxon PT OT & SLP PLLC 245 Bassett Rd Williamsville NY 14221 Erie 7166980359

Rabin, Marie B. Physical Therapy Weston Paxxon PT OT & SLP PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Rabin, Marie B. Physical Therapy Kenneth R Kurtz Pt 8705 Sheridan Dr Williamsville NY 14221 Erie 7166311212

Ramey, Amy E. Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Ramey, Amy E. Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

Ratka, Sharann Physical Therapy Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Reinstein, Julianne M. Physical Therapy Advanced Care Physical Therapy 6460 Main St 2nd Fl Williamsville NY 14221 Erie 7162822888

Religioso, Erson Physical Therapy Rose Physical Therapy PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7166970106

Rezak, Dawn M. Physical Therapy Quantum Physical Therapy Services PLLC 542 Quaker Rd East Aurora NY 14052 Erie 7164250013

Rezak, Dawn M. Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Richard, Patricia A. Physical Therapy Grand Island Physical Therapy 1491 Sheridan Dr Kenmore NY 14217 Erie 7168711100

Richard, Patricia A. Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Ricotta Jr, Anthony J. Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Ste 300 Derby NY 14047 Erie 7166313555

Ricotta Jr, Anthony J. Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Riester, Shawn P. Physical Therapy Riester, Shawn P. 2801 Wehrle Dr Ste 7 Buffalo NY 14216 Erie 7169327525

Robinson III, Joseph E. Physical Therapy Greater Buffalo Physical Ther 3950 E Robinson Rd Ste 201 West Amherst NY 14228 Erie 7166363950

Robison, Kristen M. Physical Therapy Swiatek Physical Therapy PLLC 4498 Main St Ste 24 Amherst NY 14226 Erie 7168391550

Rojas, Elisa M. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Rose Jr, Terrance M. Physical Therapy Rose Physical Therapy PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7166970106

Rose, Karen M. Physical Therapy Rose Physical Therapy PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7166970106

Ross, Andrew S. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Rowan IV, Myles W. Physical Therapy Ascend Therapy Group PC 1150 Youngs Rd Ste 210 Williamsville NY 14221 Erie 7166899201

Rowan IV, Myles W. Physical Therapy Ascend Therapy Group PC 6929 Erie Rd Derby NY 14047 Erie 7169474422

Ruh, Dennis R. Physical Therapy Southtowns Physical Therapy 4845 Transit Rd Lancaster NY 14043 Erie 7166561880

Ruh, Dennis R. Physical Therapy Southtowns Physical Therapy 100 Union Rd West Seneca NY 14224 Erie 7166754444

Ruh, Dennis R. Physical Therapy Southtowns Physical Therapy 3040 Amsdell Rd Hamburg NY 14075 Erie 7166490444

Ruschmann, Nicholas R. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Ruschmann, Nicholas R. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Ruschmann, Nicholas R. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Ruschmann, Nicholas R. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Ruschmann, Nicholas R. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Ruschmann, Nicholas R. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Ryan, Bernard J. Physical Therapy Ascend Therapy Group PC 1110 Abbott Rd Buffalo NY 14220 Erie 7168211339

Ryan, Bernard J. Physical Therapy Ascend Therapy Group PC 7008 Erie Rd Derby NY 14047 Erie 7169474422

Ryan, Matthew K. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Santarelli, Victor Physical Therapy SPortsFocus Physical Therapy 531 Virginia St Buffalo NY 14202 Erie 7163324838

Santarelli, Victor Physical Therapy SPortsFocus Physical Therapy 3940 California Rd Orchard Park NY 14127 Erie 7166622922

Santillo, Laura Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Santillo, Laura Physical Therapy Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Ste 300 Derby NY 14047 Erie 7166313555

Savitz, Wayne T. Physical Therapy Donna A Gulick and Peter H Young 8637 Main St Williamsville NY 14221 Erie 7166341578

Savitz, Wayne T. Physical Therapy Donna A Gulick and Peter H Young 3970 Harlem Rd Snyder NY 14226 Erie 7168393705

Schaus, Peter J. Physical Therapy Amherst Orthopedic Physical Therapy PC 2625 Delaware Ave Buffalo NY 14216 Erie 7168742759

Schillace, Kimberly A. Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Schultz, Kristopher R. Physical Therapy West Seneca Physical Therapy 560 Center Rd West Seneca NY 14224 Erie 7166741509

Shapiro, Rochelle Physical Therapy Weston Paxxon PT OT & SLP PLLC 245 Bassett Rd Williamsville NY 14221 Erie 7166980359

Shapiro, Rochelle Physical Therapy Weston Paxxon PT OT & SLP PLLC 111 St Gregory Ct Williamsville NY 14221 Erie 7166982894

Sheehan, Rosanne M. Physical Therapy South Shore Comprehensive Therapies 1025 Ridge Rd Buffalo NY 14218 Erie 7168224781

Shimley, Kristen J. Physical Therapy Grand Island Physical Therapy 1491 Sheridan Dr Buffalo NY 14217 Erie 7168711100

Shimley, Kristen J. Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Sickau, Lisa L. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Buffalo NY 14221 Erie 7163621552

Sickau, Lisa L. Physical Therapy Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719883

Smith, Matthew C. Physical Therapy Buffalo Back and Neck PT 1060 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168362225

Smith, Nicholas M. Physical Therapy Rose Physical Therapy PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7162048734

Soeffing, Kelsey A. Physical Therapy Michael D Calabrese MD PC 656 Elmwood Ave Buffalo NY 14222 Erie 7168830515

Specht, Deborah A. Physical Therapy Specht, Deborah 1370 Exchange St Alden NY 14004 Erie 7169373888

Steenberg, Lynn B. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Steenberg, Lynn B. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Steenberg, Lynn B. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Page 114 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Steixner, Julie A. Physical Therapy Niagara Lutheran Development dba Greenfield Health & Re 5949 Broadway St Lancaster NY 14086 Erie 7166843000

Sterlace Jr, Anthony J. Physical Therapy Advanced care physical therapy of wny pc 12845 Broadway Alden NY 14004 Erie 7166490444

Sterlace Jr, Anthony J. Physical Therapy Advanced care physical therapy of wny pc 3040 Amsdell Rd Ste 207 B Hamburg NY 14075 Erie 7166490444

Sterns, David C. Physical Therapy Optimal Occupational and Physical Therapy Associates Se 2495 Main St Ste 234 Buffalo NY 14214 Erie 7168365929

Strobino, Gregg A. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Studer, Johanna L. Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Styn, Julie N. Physical Therapy Ken-Ton Physical Therapy 2438 Elmwood Ave Kenmore NY 14217 Erie 7168739154

Swanson, Scott W. Physical Therapy Susan E Bennett & Associates, PC 3350 Southwestern Blvd Orchard Park NY 14127 Erie 7166902051

Swiatek, Nicole M. Physical Therapy Swiatek Physical Therapy PLLC 4498 Main St Ste 24 Amherst NY 14226 Erie 7168391550

Szymanski, Walter R. Physical Therapy Western New York Physical And Occupational Therapy 12395 Olean Rd Chaffee NY 14030 Erie 7164965550

Szymanski, Walter R. Physical Therapy Western New York Physical And Occupational Therapy 2700 N Forest Rd Ste 101 Getzville NY 14068 Erie 7166393330

Szymanski, Walter R. Physical Therapy Western New York Physical And Occupational Therapy 162 Mill St Williamsville NY 14221 Erie 7166318081

Szymanski, Walter R. Physical Therapy Western New York Physical And Occupational Therapy 545 Delaware St Tonawanda NY 14150 Erie 7166945385

Szymanski, Walter R. Physical Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Tanski, Scott A. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

Thurnherr, Dawn M. Physical Therapy Creekside Physical Therapy Pc 14318 Rte 62 Collins NY 14034 Erie 7165328129

Tiberi, Jamie R. Physical Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Tiberi, Jamie R. Physical Therapy Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Tiberi, Jamie R. Physical Therapy Western New York Physical And Occupational Therapy 2700 N Forest Rd Ste 101 Getzville NY 14068 Erie 7166393311

Tiberi, Jamie R. Physical Therapy Western New York Physical And Occupational Therapy 12395 Olean Rd Chaffee NY 14030 Erie 7164965550

Tiberi, Jamie R. Physical Therapy Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Tirone, Michael A. Physical Therapy Step By Step Physical Therapy Pc 56 Main St Akron NY 14001 Erie 7165421135

Tirone, Michael A. Physical Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Tojek, Edward T. Physical Therapy Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Tonsoline, Peter B. Physical Therapy Sports Rehab Physical Therapy, PLLC 5102 Transit Rd Depew NY 14043 Erie 7166839310

Tonsoline, Peter B. Physical Therapy Sports Rehab Physical Therapy, PLLC 27 Franklin St Springville NY 14141 Erie 7165922483

Tonsoline, Peter B. Physical Therapy Sports Rehab Physical Therapy, PLLC 4545 Transit Rd Ste 640 Williamsville NY 14221 Erie 7166398212

Tonsoline, Philip A. Physical Therapy Sports Rehab Physical Therapy, PLLC 4545 Transit Rd Ste 640 Williamsville NY 14221 Erie 7166398212

Tonsoline, Philip A. Physical Therapy Sports Rehab Physical Therapy, PLLC 27 Franklin St Springville NY 14141 Erie 7165922483

Tonsoline, Philip A. Physical Therapy Sports Rehab Physical Therapy, PLLC 5102 Transit Rd Depew NY 14043 Erie 7166839310

Travis, Beth D. Physical Therapy Lancaster Depew Cheektowaga Physical Therapy Pc 3260 Walden Ave Ste 100 Depew NY 14043 Erie 7166510100

Travis, John D. Physical Therapy Lancaster Depew Cheektowaga Physical Therapy Pc 3260 Walden Ave Ste 100 Depew NY 14043 Erie 7166510100

Travis, John D. Physical Therapy Lancaster Depew Cheektowaga Physical Therapy Pc 2324 Bowen Rd Elma NY 14059 Erie 7166520200

Trunzo, Lisa Z. Physical Therapy Lisa Z Trunzo PT 2154 Grand Island Blvd Grand Island NY 14072 Erie 7167733300

Trunzo, Lisa Z. Physical Therapy Grand Island Physical Therapy 1801 Grand Island Blvd Grand Island NY 14072 Erie 7167734323

Trunzo, Lisa Z. Physical Therapy Grand Island Physical Therapy 1491 Sheridan Dr Kenmore NY 14217 Erie 7168711100

Trzewieczynski, Ariel T. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7166568600

Ucci, Amanda B. Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 4535 Southwestern Blvd Sts 805 and 806 Hamburg NY 14075 Erie 7166488700

Ucci, Amanda B. Physical Therapy Kirchmeyer & Goode Physical Therapist Pcdba Proactive S 240 Red Tail Dr Sts 3 and 4 Orchard Park NY 14127 Erie 7166749600

Vaeth, Jenna C. Physical Therapy Body Dynamics Physical Therapy & Wellnes 9570 Transit Rd E Amherst NY 14051 Erie 7163488734

Vargovich, Laura M. Physical Therapy Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301020

Vollmer, Shaun M. Physical Therapy Riester, Shawn P. 2801 Wehrle Dr Ste 7 Williamsville NY 14221 Erie 7169327525

Vollmer, Shaun M. Physical Therapy Southtowns Physical Therapy 100 Union Rd Buffalo NY 14224 Erie 7166754444

Walter, Amy J. Physical Therapy Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Buffalo NY 14225 Erie 7168445000

Wambold, Jason M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Wambold, Jason M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Wambold, Jason M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Ward, Kevin M. Physical Therapy Step By Step Physical Therapy Pc 56 Main St Akron NY 14001 Erie 7165421135

Wasbes, Carla M. Physical Therapy Weston Paxxon PT OT & SLP PLLC 11 Saint Gregory Ct Williamsville NY 14221 Erie 7166982894

Wasbes, Carla M. Physical Therapy Weston Paxxon PT OT & SLP PLLC 245 Bassett Rd Williamsville NY 14221 Erie 7166980359

Weber, Thomas L. Physical Therapy Buffalo Back & Neck Physical Therapy PC 1060 Niagara Falls Blvd Ste 5 Tonawanda NY 14150 Erie 7168362712

West, David A. Physical Therapy Donald J Brown, PT, DPT, PLLC 692 Millersport Hwy Amherst NY 14226 Erie 7168399529

Whieldon, Terry J. Physical Therapy Sports and Physical Fitness 4063 N Buffalo Rd Orchard Park NY 14127 Erie 7166622949

White, Ronald P. Physical Therapy Buffalo Physical Therapy & Sports Rehab 192 Park Club Ln Ste 110 Williamsville NY 14221 Erie 7166329200

Whitenight, Jamie Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Wiatrowski, Jessica A. Physical Therapy Donald J Brown, PT, DPT, PLLC 2075 Sheridan Dr Buffalo NY 14223 Erie 7164643251

Wiatrowski, Jessica A. Physical Therapy Sports Rehab Physical Therapy, PLLC 4545 Transit Rd Ste 640 Williamsville NY 14221 Erie 7166398212

Wiatrowski, Jessica A. Physical Therapy Sports Rehab Physical Therapy, PLLC 5102 Transit Rd Depew NY 14043 Erie 7166839310

Wiatrowski, Jessica A. Physical Therapy Sports Rehab Physical Therapy, PLLC 27 Franklin St Springville NY 14141 Erie 7165922483

Wiatrowski, Jessica A. Physical Therapy Donald J Brown, PT, DPT, PLLC 692 Millersport Hwy Buffalo NY 14226 Erie 7168399529

Wilson, Ellen B. Physical Therapy Creekside Physical Therapy Pc 14318 Rte 62 Collins NY 14034 Erie 7165328129

Winiewicz, Thomas W. Physical Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Wolfley, Julie M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Wolfley, Julie M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Wolfley, Julie M. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Wolfley, Julie M. Physical Therapy Sports Physical Therapy Of New York PC 2540 Sheridan Dr Tonawanda NY 14150 Erie 7168620567

Page 115 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Wolfley, Julie M. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Wolfley, Julie M. Physical Therapy Sports Physical Therapy Of New York PC 285 Delaware Ave Ste 116 Buffalo NY 14202 Erie 7163418214

Wood, Daniel W. Physical Therapy Western New York Physical And Occupational Therapy 6301 Transit Rd Depew NY 14043 Erie 7166840400

Woodrich, Jeffrey J. Physical Therapy Buffalo Rehab Group P T 8750 Transit Rd Ste 120 East Amherst NY 14051 Erie 7165681251

Woodrich, Jeffrey J. Physical Therapy Buffalo Rehab Group P T 150 Tech Dr Williamsville NY 14221 Erie 7162768641

Wrotniak, Brian H. Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Yeung, Wing Ki Physical Therapy Buffalo Rehab Group P T 8750 Transit Rd Ste 120 East Amherst NY 14051 Erie 7165681251

Young, Peter H. Physical Therapy Donna A Gulick and Peter H Young 8637 Main St Buffalo NY 14221 Erie 7166341578

Young, Peter H. Physical Therapy Donna A Gulick and Peter H Young 3970 Harlem Rd Snyder NY 14226 Erie 7168393705

Zablonski, Paula M. Physical Therapy Buffalo Rehab Group P T 2100 Union Rd West Seneca NY 14224 Erie 7162130772

Zambron, Lisa R. Physical Therapy Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Zarbo, Mark T. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 100 College Pkwy Ste 100 Williamsville NY 14221 Erie 7166260093

Zarbo, Mark T. Physical Therapy Buffalo Spine Medicine and Rehab PLLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166260093

Zdrojewski, Thomas F. Physical Therapy Buffalo Physical Therapy & Sports Rehab 192 Park Club Ln Ste 110 Williamsville NY 14221 Erie 7166329200

Zentz, Robert Physical Therapy Step By Step Physical Therapy Pc 56 Main St Akron NY 14001 Erie 7165421135

Zhou, Kehua Physical Therapy Daemen College Physical Therapy, Inc 2355 Union Rd Ste 100 Cheektowaga NY 14227 Erie 7166718073

Zielinski, Cheryl Physical Therapy Southtowns Physical Therapy 100 Union Rd West Seneca NY 14224 Erie 7166754444

Zielinski, Cheryl Physical Therapy Southtowns Physical Therapy 4845 Transit Rd Lancaster NY 14043 Erie 7166561880

Zugelder, Kimberly Physical Therapy Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Arshad, Hassan Plastic Surg Head & Neck Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Gupta, Vishal Plastic Surg Head & Neck Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ozturk, Cemile N. Plastic Surg Head & Neck Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Tomljanovich, Paul I. Plastic Surg Head & Neck Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983073

Tomljanovich, Paul I. Plastic Surg Head & Neck Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Anain, Shirley A. Plastic Surgery Shirley A Anain MD PC 4949 Harlem Rd Ste 302 Amherst NY 14226 Erie 7168381333

Anain, Shirley A. Plastic Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787149

Bhangoo, Kulwant S. Plastic Surgery Bhangoo, Kulwant 5483 Sheridan Dr Buffalo NY 14221 Erie 7166337456

Bhangoo, Kulwant S. Plastic Surgery Bhangoo, Kulwant 4 Cazenovia St Buffalo NY 14220 Erie 7168264800

Cusenz, Bruce J. Plastic Surgery Cusenz, Bruce 1630 Maple Rd Ste 200 Williamsville NY 14221 Erie 7166390045

Dauria, Danielle M. Plastic Surgery Robert J Perry MD PLLC 3580 Sheridan Dr Ste 120 Amherst NY 14226 Erie 7168836666

Giacobbe, Andrew P. Plastic Surgery Andrew Giacobbe Md 7 Hopkins Rd Williamsville NY 14221 Erie 7166345555

Giacobbe, Andrew P. Plastic Surgery Andrew Giacobbe Md 3040 Amsdell Rd Hamburg NY 14075 Erie 7168367646

Gonzalez Doldan, Federico G. Plastic Surgery Gonzalez-Doldan, Federico 585 Delaware St Tonawanda NY 14150 Erie 7166935005

Graff, Jonathan A. Plastic Surgery Assoc Plastic Surgeons Of Wny Pc 5611 Main St Williamsville NY 14221 Erie 7166318500

Lohman, Robert F. Plastic Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Loree, Thom R. Plastic Surgery Delaware Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Moon, Wong K. Plastic Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Perry, Robert J. Plastic Surgery Robert J Perry MD PLLC 3580 Sheridan St Ste 120 Buffalo NY 14226 Erie 7168836666

Perry, Robert J. Plastic Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787149

Rajendran, Lakshmanan Plastic Surgery Rajendran, Lakshmanan 3649 Harlem Rd Buffalo NY 14215 Erie 7168359192

Rajendran, Lakshmanan Plastic Surgery Rajendran, Lakshmanan 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166748555

Rajendran, Lakshmanan Plastic Surgery Rajendran, Lakshmanan 310 Sterling Dr Buffalo NY 14224 Erie 7166748555

Rajendran, Lakshmanan Plastic Surgery Terrace View 3649 Harlem Rd Buffalo NY 14215 Erie 7168359292

Rigan, David M. Plastic Surgery Assoc Plastic Surgeons Of Wny Pc 3725 N Buffalo Rd Ste C Orchard Park NY 14127 Erie 7166318500

Rigan, David M. Plastic Surgery Assoc Plastic Surgeons Of Wny Pc 5611 Main St Williamsville NY 14221 Erie 7166318500

Schultz, Raymond O. Plastic Surgery Assoc Plastic Surgeons Of Wny Pc 5611 Main St Williamsville NY 14221 Erie 7166318500

Schultz, Raymond O. Plastic Surgery Assoc Plastic Surgeons Of Wny Pc 3725 N Buffalo Rd Ste C Orchard Park NY 14127 Erie 7166318500

Sharf, Zvi Plastic Surgery Assoc Plastic Surgeons Of Wny Pc 5611 Main St Williamsville NY 14221 Erie 7166318500

Shastri, Subramanya R. Plastic Surgery Shastri, Subramanya 2157 Main St Buffalo NY 14214 Erie 7168621810

Shastri, Subramanya R. Plastic Surgery Shastri, Subramanya 17 Limestone Dr Ste 1 Williamsville NY 14221 Erie 7165653390

Shatkin Jr, Samuel Plastic Surgery Samuel Shatkin Jr MD PLLC 2500 Kensington Ave Amherst NY 14226 Erie 7168391700

Shatkin Jr, Samuel Plastic Surgery Samuel Shatkin Jr MD PLLC 268 Main St East Aurora NY 14052 Erie 7168391700

Singh, Kamaljot Plastic Surgery Buffalo Medical Group 325 Essjay Rd Williamsville NY 14221 Erie 7166301447

Singh, Kamaljot Plastic Surgery Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301447

Singh, Kamaljot Plastic Surgery Buffalo Medical Group 2355 Union Rd Cheektowaga NY 14227 Erie 7168578603

Singh, Kamaljot Plastic Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301447

Sultz, Jerald R. Plastic Surgery Sultz, Jerald 1301 N Forest Rd Ste 1 Williamsville NY 14221 Erie 7166341970

Adornetto, Gregory J. Podiatry Adornetto, Gregory 179 Buffalo St Hamburg NY 14075 Erie 7166492892

Anain Jr, Joseph M. Podiatry Keating & Keating 30 N Union Rd Buffalo NY 14226 Erie 7167592004

Anain Jr, Joseph M. Podiatry Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Anain Jr, Joseph M. Podiatry Keating & Keating 9600 Main St Clarence NY 14031 Erie 7167592004

Anain Jr, Joseph M. Podiatry Keating & Keating 2121 Main St Ste 214 Buffalo NY 14214 Erie 7168382983

Aquino, John M. Podiatry Aquino, John 5011 Broadway Depew NY 14043 Erie 7166848955

Aquino, John M. Podiatry Aquino, John 2047 Clinton St Buffalo NY 14206 Erie 7168270100

Aquino, John M. Podiatry Aquino, John 206 Ontario St Buffalo NY 14207 Erie 7168763600

Aquino, Michael D. Podiatry The Foot and Ankle Center 929 Brighton Rd Tonawanda NY 14150 Erie 7168371500

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Aquino, Michael D. Podiatry Aquino, Michael 929 Brighton Rd Tonawanda NY 14150 Erie 7168371500

Aquino, Michael D. Podiatry Aquino, Michael 564 Niagara St Buffalo NY 14201 Erie 7168841325

Ber, Leon Podiatry Ber, Leon 9 Royalwoods Ct Williamsville NY 14221 Erie 7168955454

Bhattacharyya, Bhaskar Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 3154774528

Billing, Lee D. Podiatry Billing, Lee 888 Center Rd West Seneca NY 14224 Erie 7166756121

Billing, Lee D. Podiatry Billing, Lee 6970 Erie Rd Derby NY 14047 Erie 7169419147

Bove, Jennifer L. Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Burruano, James C. Podiatry Podiatry Surgeon Of Wny Pc James Burruano Dpm 94 Olean Rd East Aurora NY 14052 Erie 7166520188

Burruano, James C. Podiatry Podiatry Surgeon Of Wny Pc James Burruano Dpm 80 Delaware Rd Buffalo NY 14217 Erie 7168745540

Burruano, James C. Podiatry Northwest Buffalo Community Health 155 Lawn Ave Buffalo NY 14207 Erie 7168752904

Burruano, James C. Podiatry Northwest Buffalo Community Health 300 Niagara St Buffalo NY 14201 Erie 7162428600

Burruano, James C. Podiatry Podiatry Surgeon Of Wny Pc James Burruano Dpm 1315 Jefferson Ave Buffalo NY 14208 Erie 7163323797

Butler, Michael P. Podiatry Keating & Keating 2121 Main St Ste 214 Buffalo NY 14214 Erie 7168382983

Butler, Michael P. Podiatry Keating & Keating 9600 Main St Clarence NY 14031 Erie 7167592004

Butler, Nancy A. Podiatry Butler, Nancy A. 815 Hopkins Rd Buffalo NY 14221 Erie 7164442159

Butler, Nancy A. Podiatry Butler, Nancy A. 4459 Bailey Ave Amherst NY 14226 Erie 7168352543

Butler, Nancy A. Podiatry Butler, Nancy A. 8333 Black Walnut Dr East Amherst NY 14051 Erie 7164442159

Butler, Nancy A. Podiatry Butler, Nancy A. 2850 Grand Island Blvd Grand Island NY 14072 Erie 7167735900

Butler, Nancy A. Podiatry Butler, Nancy A. 2365 Union Rd Cheektowaga NY 14227 Erie 7168262010

Butler, Nancy A. Podiatry Butler, Nancy A. 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Butler, Nancy A. Podiatry Butler, Nancy A. 6060 Armor Rd Orchard Park NY 14127 Erie 7166624433

Butler, Nancy A. Podiatry Butler, Nancy A. 200 Bassett Rd Williamsville NY 14221 Erie 7166896681

Canzoneri, Joseph R. Podiatry United Memorial Medical Center 127 North St Buffalo NY 14201 Erie 5853445372

Caputi, Richard A. Podiatry Caputi, Richard A. 3407 Delaware Ave Kenmore NY 14217 Erie 7168730039

Carrel, Jeffrey M. Podiatry Podiatry Affiliates Pc Phymedco 403 Main St Brisbane Bldg Ste 603 Buffalo NY 14203 Erie 7168527800

Carrel, Jeffrey M. Podiatry Podiatry Affiliates Pc Phymedco 27 Franklin St Springville NY 14141 Erie 7165924540

Carrel, Jeffrey M. Podiatry Podiatry Affiliates Pc Phymedco 3980 Sheridan Dr Ste 308 Amherst NY 14226 Erie 7168393930

Culliton, Phillip C. Podiatry Phillip C Culliton DPM PC 2700 Sheridan Dr Tonawanda NY 14150 Erie 7168352617

Davidson, David M. Podiatry Podiatry Affiliates Pc Phymedco 27 Franklin St Springville NY 14141 Erie 7165924540

Davidson, David M. Podiatry Podiatry Affiliates Pc Phymedco 3980 Sheridan Dr Ste 308 Dent Tower Amherst NY 14226 Erie 7168393930

Davidson, David M. Podiatry Podiatry Affiliates Pc Phymedco 403 Main St Brisbane Bldg Ste 603 Buffalo NY 14203 Erie 7168527800

Davidson, David M. Podiatry University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Davidson, David M. Podiatry Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Davidson, David M. Podiatry University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

DeFrancis, Roy R. Podiatry Roy Defrancis DPM 570 French Rd Cheektowaga NY 14227 Erie 7166681610

DeVincentis, Anthony F. Podiatry DeVincentis, Anthony 4200 N Buffalo Rd Orchard Park NY 14127 Erie 7166621003

DeVincentis, Anthony F. Podiatry DeVincentis, Anthony 1094 E Lovejoy St Buffalo NY 14206 Erie 7168973720

DeVincentis, Joseph A. Podiatry Orchard Park Podiatry PLLC 3065 Southwestern Blvd Ste 200 Orchard Park NY 14127 Erie 7166772601

Fanara, Ross L. Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Ferrelli, Cynthia S. Podiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482202

Ferrelli, Cynthia S. Podiatry Sheehan Memorial Hospital 330 Harris Hill Rd Ste B Williamsville NY 14221 Erie 7166311133

Ferrelli, Cynthia S. Podiatry Ferrelli, Cynthia 330 Harris Hill Rd Ste B Buffalo NY 14221 Erie 7166311133

Finkelstein, Mark S. Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Finkelstein, Mark S. Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168623117

Finkelstein, Mark S. Podiatry Finkelstein, Mark 1540 Ellicott Creek Rd Tonawanda NY 14150 Erie 7166952244

Fitzgerald, Barry J. Podiatry Fitzgerald, Barry 430 S Park Ave Buffalo NY 14204 Erie 7168476610

Fitzgerald, Barry J. Podiatry Fitzgerald, Barry 843 Mckinley Pkwy Buffalo NY 14220 Erie 7168220118

Fitzgerald, Barry J. Podiatry Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fitzpatrick, Edward T. Podiatry Podiatry Affiliates Pc Phymedco 27 Franklin St Springville NY 14141 Erie 7165924540

Fitzpatrick, Edward T. Podiatry Podiatry Affiliates Pc Phymedco 403 Main St Brisbane Bldg Ste 603 Buffalo NY 14203 Erie 7168527800

Fitzpatrick, Edward T. Podiatry Podiatry Affiliates Pc Phymedco 3980 Sheridan Dr Ste 308 Buffalo NY 14221 Erie 7168393930

Fortman, Diane H. Podiatry Fortman, Diane H. 2448 Elmwood Ave Buffalo NY 14217 Erie 7168757878

Gelia, Maurice M. Podiatry Gelia, Maurice 1540 Ellicott Creek Rd Tonawanda NY 14150 Erie 7167432000

Gelia, Maurice M. Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Genau, Joseph M. Podiatry Aspire of WNY Inc 7 Community Dr Cheektowaga NY 14225 Erie 7165055540

Genau, Joseph M. Podiatry Horizon Health Services 7 Community Dr Buffalo NY 14225 Erie 7165055630

Goldstein, Kenneth T. Podiatry Podiatry Affiliates Pc Phymedco 27 Franklin St Springville NY 14141 Erie 7165924540

Goldstein, Kenneth T. Podiatry Podiatry Affiliates Pc Phymedco 403 Main St Brisbane Bldg Ste 603 Buffalo NY 14203 Erie 7168527800

Goldstein, Kenneth T. Podiatry Podiatry Affiliates Pc Phymedco 3980 Sheridan Dr Ste 308 Dent Tower Amherst NY 14226 Erie 7168393930

Gutsin, Steven B. Podiatry Gutsin, Steven 41 Bender Dr Orchard Park NY 14127 Erie 7166466006

Hanzly, Michael I. Podiatry Hanzly, Michael 4855 CAMP RD Hamburg NY 14075 Erie 7168230049

Hanzly, Michael I. Podiatry Hanzly, Michael 2267 Seneca St Buffalo NY 14210 Erie 7168230049

Hanzly, Michael I. Podiatry Hanzly, Michael 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7168230049

Hassenfratz, Jay T. Podiatry Southgate Medical Group LLP 380 Cleveland Dr West Seneca NY 14224 Erie 7167120851

Hassenfratz, Jay T. Podiatry Hassenfratz, Thomas 380 Cleveland Dr Buffalo NY 14215 Erie 7168367156

Hassenfratz, Jay T. Podiatry Hassenfratz, Thomas 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Page 117 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Hassenfratz, Jay T. Podiatry Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Hassenfratz, Thomas A. Podiatry Hassenfratz, Thomas 1026 Union Rd West Seneca NY 14224 Erie 7168367156

Hassenfratz, Thomas A. Podiatry Hassenfratz, Thomas 380 Cleveland Dr Buffalo NY 14215 Erie 7168367156

Hewson, Robert A. Podiatry Hewson, Robert 344 Niagara Falls Blvd Buffalo NY 14223 Erie 7168338094

Hook, Stephanie R. Podiatry Roy Defrancis DPM 570 French Rd Cheektowaga NY 14227 Erie 7166681610

Hurley, John P. Podiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482202

Hurley, John P. Podiatry Excelsior Orthopaedics Llp 240 Red Tail Ste 1 and 2 Orchard Park NY 14127 Erie 7162509999

Hurley, John P. Podiatry Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Izzo, Michael A. Podiatry Izzo, Michael 1045 Wehrle Dr Buffalo NY 14221 Erie 7166881464

Keating, Daniel B. Podiatry Keating & Keating 9600 Main St Clarence NY 14031 Erie 7167592004

Keating, Daniel B. Podiatry Keating & Keating 2121 Main St Ste 106 Buffalo NY 14214 Erie 7168719867

Keating, Sean E. Podiatry Keating & Keating 2121 Main St Ste 214 Buffalo NY 14214 Erie 7168382983

Keating, Sean E. Podiatry Keating & Keating 9600 Main St Clarence NY 14031 Erie 7167592004

Keating, Sean E. Podiatry Orchard Park Podiatry PLLC 3065 Southwestern Blvd Ste 200 Orchard Park NY 14127 Erie 7166772601

LaCivita, Michael D. Podiatry Keating & Keating William E Mosher Hlth Ctr 899 Main St Buffalo NY 14203 Erie 7168782700

LaCivita, Michael D. Podiatry Keating & Keating 9600 Main St Clarence NY 14031 Erie 7167592004

LaCivita, Michael D. Podiatry Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

LaCivita, Michael D. Podiatry Keating & Keating 2121 Main St Ste 214 Buffalo NY 14214 Erie 7168382983

LaCivita, Michael D. Podiatry Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166686170

Maulucci, Marina A. Podiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Maulucci, Marina A. Podiatry Maulucci, Marina 191 North St Ste 2 Buffalo NY 14201 Erie 7168868289

Maulucci, Marina A. Podiatry Maulucci, Marina 1540 Ellicott Crk Rd Tonawanda NY 14150 Erie 7166952244

Nasca, Joseph M. Podiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482180

Nasca, Joseph M. Podiatry Nasca, Joseph 369 Kenmore Ave Buffalo NY 14223 Erie 7168330225

Nasca, Joseph M. Podiatry Kenmore Mercy Hospital 300 Two Mile Creek Rd Tonawanda NY 14150 Erie 7164476450

Nasca, Paul C. Podiatry Nasca, Paul 2562 Walden Ave Ste 105 Cheektowaga NY 14225 Erie 7166833330

Panek, William N. Podiatry Panek, William 969 Maryvale Dr Buffalo NY 14225 Erie 7169373310

Panek, William N. Podiatry Panek, William 13104 Broadway Alden NY 14004 Erie 7169373310

Penn, Howard A. Podiatry Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Penn, Howard A. Podiatry Penn, Howard 1271 Ridge Rd Lackawanna NY 14218 Erie 7168249835

Perelstein, David M. Podiatry Kaleida Health 100 High St Podiatry Clinic Bldg D Ground Fl Buffalo NY 14203 Erie 7168592555

Perelstein, David M. Podiatry Podiatry Affiliates Pc Phymedco 27 Franklin St Springville NY 14141 Erie 7165924540

Perelstein, David M. Podiatry Podiatry Affiliates Pc Phymedco 403 Main St Brisbane Bldg Ste 603 Buffalo NY 14203 Erie 7168527800

Perelstein, David M. Podiatry Podiatry Affiliates Pc Phymedco 3980 Sheridan Dr Ste 308 Dent Tower Amherst NY 14226 Erie 7168393930

Perillo, Frank B. Podiatry Perillo, Frank 210 E Main St Springville NY 14141 Erie 7165923644

Perillo, Frank B. Podiatry Perillo, Frank 1431 Hertel Ave Buffalo NY 14216 Erie 7168381131

Pierce, William S. Podiatry Kaleida Health 900 Hertel Ave Buffalo NY 14216 Erie 7168711571

Pierce, William S. Podiatry Pierce, William 4184 Seneca St Ste 203 West Seneca NY 14224 Erie 7166753555

Pietrusik, Michael J. Podiatry Pietrusik, Michael 3277 S Park Ave Buffalo NY 14218 Erie 7168223411

Rhinehart, Francine C. Podiatry Nasca, Paul 2562 Walden Ave Ste 105 Cheektowaga NY 14225 Erie 7166833330

Ribes, Susan J. Podiatry Ribes, Susan 3085 Southwestern Blvd Ste 102 Orchard Park NY 14127 Erie 7166755252

Riznyk, Peter J. Podiatry Riznyk, Peter 6272 W Quaker Rd Orchard Park NY 14127 Erie 7166627729

Rudewicz, Robert J. Podiatry Lancaster Depew Podiatry 5429 Broadway Lancaster NY 14086 Erie 7166841010

Ruggiero, Samuel F. Podiatry Ruggiero, Samuel 10440 Main St Clarence NY 14031 Erie 7167596005

Ruggiero, Samuel F. Podiatry Ruggiero, Samuel 2507 Harlem Rd Cheektowaga NY 14225 Erie 7168966262

Sciandra, Joseph A. Podiatry Sciandra, Joseph 850 Hopkins Rd Williamsville NY 14221 Erie 7166889641

Sciandra, Joseph A. Podiatry Sciandra, Joseph 1275 Hertel Ave Buffalo NY 14216 Erie 7168753313

Skalski, James G. Podiatry Skalski, James 3884 Broadway Buffalo NY 14227 Erie 7166837160

Skalski, James G. Podiatry Sheehan Memorial Hospital 330 Harris Hill Rd Ste B Williamsville NY 14221 Erie 7166311133

Skalski, James G. Podiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Szalach, Michael J. Podiatry Szalach, Michael 1384 Union Rd West Seneca NY 14224 Erie 7166752331

Tiberia, Nicholas Podiatry Tiberia, Nicholas 100 Union Rd West Seneca NY 14224 Erie 7166740375

Vasiliadis, George C. Podiatry Vasiliadis, George 190 Main St Tonawanda NY 14150 Erie 7166931050

Vona, David P. Podiatry Vona, David P. 9 Stellane Dr Angola NY 14006 Erie 7165436239

Weisbrot, Aaron Podiatry Weisbrot, Aaron 1241 Colvin Blvd Buffalo NY 14223 Erie 7168773624

White, Jason T. Podiatry Podiatry Solutions of WNY PLLC 15 S Forest Rd Williamsville NY 14221 Erie 7166345993

Wilson, Breeann N. Podiatry Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Wilson, Breeann N. Podiatry Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Amherst NY 14226 Erie 7166890040

Wilson, Breeann N. Podiatry Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W West Seneca NY 14224 Erie 7166683600

Wilson, Breeann N. Podiatry Keating & Keating 2121 Main St Ste 214 Buffalo NY 14214 Erie 7168382983

Winiecki, Dennis G. Podiatry Dennis G Winiecki Dpm 5181 Transit Rd Buffalo NY 14221 Erie 7166345767

Wright, Susan M. Podiatry Kaleida Health 100 High St Podiatry Clinic Bldg D Group Fl Buffalo NY 14203 Erie 7168592175

Wright, Susan M. Podiatry Wright, Susan 344 Niagara Falls Blvd Buffalo NY 14223 Erie 7168332680

Zimmer, Robert A. Podiatry Robert Zimmer Dpm Pc 826 Lake St Angola NY 14006 Erie 7165496977

Cianciolo, Thomas J. Podiatry w/o mjr surgery Cianciolo, Thomas 4883 Winding Ln Clarence NY 14031 Erie 7167596850

Salada Conroy, Jeanne Psychiatric Nurse Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Page 118 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Abbasi, Israr A. Psychiatry Jamestown Psychiatric PC 2625 Harlem Rd Ste 160 Buffalo NY 14225 Erie 7164832603

Abbasi, Israr A. Psychiatry Jamestown Psychiatric PC 7020 Erie Rd Derby NY 14047 Erie 7165264041

Adelaja, Abiola O. Psychiatry University Psychiatric Practice Inc 462 Grider St Buffalo NY 14215 Erie 7168983462

Adragna, Michael S. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Adragna, Michael S. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168351246

Adragna, Michael S. Psychiatry Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Adragna, Michael S. Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168351246

Adragna, Michael S. Psychiatry University Psychiatric Practice Inc 1028 Main St Buffalo NY 14222 Erie 7168595454

Ahmed, Syed S. Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Ahmed, Syed S. Psychiatry Western New York Medical 4979 Harlem Rd Ste 1 Williamsville NY 14221 Erie 7169234380

Ahmed, Syed S. Psychiatry Ahmed & Ahmed Physicians PC 8207 Main St Ste 7 And 8 Williamsville NY 14221 Erie 7166264200

Ahmed, Syed S. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Ahmed, Syed S. Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Ahmed, Syed S. Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166491342

Arana, Belito J. Psychiatry University Psychiatric Practice Inc 462 Grider St Buffalo NY 14215 Erie 7168984857

Ashton, Adam K. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Badgaiyan, Rajendra D. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Badgaiyan, Rajendra D. Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168983465

Bakhai, Yogesh D. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984536

Bakhai, Yogesh D. Psychiatry Kaleida Health 3 Gates Circle Buffalo NY 14209 Erie 7168874600

Bakhai, Yogesh D. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592589

Belen, Alfred D. Psychiatry Dent Neurologic Group LLP 3980 Sheridan Dr Ste 500 Amherst NY 14226 Erie 7162502000

Bennett, Richard G. Psychiatry Suburban Psychiatric Assoc 240 Red Tail Ste 7 and 8 Orchard Park NY 14127 Erie 7166893333

Brooks, Victoria L. Psychiatry University Psychiatric Practice Inc 462 Grider St Buffalo NY 14215 Erie 7168984536

Brown, Betty J. Psychiatry Kaleida Health 80 Goodrich St Buffalo NY 14203 Erie 7168591675

Brown, Betty J. Psychiatry 10225 Main St Ste 1 Clarence NY 14031 Erie 7163359688

Burnett, George J. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Burnett, George J. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984536

Capote, Horacio A. Psychiatry Oscar S Lopez Md Pc 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Capote, Horacio A. Psychiatry Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Cartagena, Maria T. Psychiatry Kaleida Health PO Box 1392 Buffalo NY 14240 Erie 7168598396

Cartagena, Maria T. Psychiatry Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Cartagena, Maria T. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Cartagena, Maria T. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Charles, Roderick E. Psychiatry Charles, Roderick 142 N Pearl St Buffalo NY 14202 Erie 7168832782

Chaudhry, Monir A. Psychiatry Jamestown Psychiatric PC 7020 Erie Rd Derby NY 14047 Erie 7165264041

Chaudhry, Monir A. Psychiatry Jamestown Psychiatric PC 2625 Harlem Rd Ste 160 Buffalo NY 14225 Erie 7164832603

Conboy, Thomas A. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Cummings, Michael R. Psychiatry University Psychiatric Practice Inc 462 Grider St Ste 1168 Buffalo NY 14215 Erie 7168984857

Del Regno, Paula Psychiatry University Psychiatric Practice Inc 1400 Sweethome Rd Ste 4 Buffalo NY 14228 Erie 7166884180

Del Regno, Paula Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Del Regno, Paula Psychiatry University Psychiatric Practice Inc 100 High St Buffalo NY 14203 Erie 7168595600

Dobson, Kim M. Psychiatry Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Dobson, Kim M. Psychiatry Terrace View 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168983255

Dobson, Kim M. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168983255

Elberg, Zhanna Psychiatry University Psychiatric Practice Inc 462 Grider St Ste 1168 Buffalo NY 14215 Erie 7168984857

Elberg, Zhanna Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Ste 130 Amherst NY 14226 Erie 7168351246

Ghosh, Biswarup M. Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Ste 1168 Buffalo NY 14215 Erie 7168983465

Godzala, Michael E. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Gokhale, Vinayak S. Psychiatry Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Gokhale, Vinayak S. Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Gokhale, Vinayak S. Psychiatry Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Gokhale, Vinayak S. Psychiatry Western New York Medical 4985 Harlem Rd Amherst NY 14226 Erie 7169234380

Gokhale, Vinayak S. Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Gokhale, Vinayak S. Psychiatry Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168222028

Gokhale, Vinayak S. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984587

Gokhale, Vinayak S. Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166491342

Gokhale, Vinayak S. Psychiatry Western New York Medical 4979 Harlem Rd Ste 1 Amherst NY 14226 Erie 7169234380

Gokhale, Vinayak S. Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Guppenberger, Michael T. Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168984536

Gupta, Sanjay Psychiatry Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Haak, Jennifer L. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984536

Hallett, Michael P. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Haque, Shabrin A. Psychiatry Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Haque, Shabrin A. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Hashim, Junaid Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Page 119 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Hashim, Junaid Psychiatry El-Khoury, Naji 1275 Delaware Ave Ste 303 Buffalo NY 14209 Erie 7168865493

Hashim, Junaid Psychiatry Hashim, Junaid 1825 Maple Rd Ste 200 Williamsville NY 14221 Erie 7168865493

Hays, Thomas A. Psychiatry Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Hernandez, Sergio Psychiatry University Psychiatric Practice Inc 462 Grider St 1168 Buffalo NY 14215 Erie 7168984857

Hurley III, Patrick T. Psychiatry Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Hurley III, Patrick T. Psychiatry Hurley, Patrick 224 E Main St Springville NY 14141 Erie 7165928174

Improta, John M. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168983462

Jaffri, Naureen R. Psychiatry Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476142

Jaffri, Naureen R. Psychiatry Jaffri Medical Associates LLC 2800 Sweethome Rd Ste 8 Buffalo NY 14228 Erie 7166910639

Jaffri, Naureen R. Psychiatry Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621982

Jaffri, Qasim S. Psychiatry Kenmore Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Jaffri, Qasim S. Psychiatry Jaffri Medical Associates LLC 2800 Sweethome Rd Ste 8 Buffalo NY 14228 Erie 7166910639

Jaffri, Qasim S. Psychiatry Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621759

Jaffri, Syed S. Psychiatry Jaffri Medical Associates LLC 2800 Sweethome Rd Ste 8 Buffalo NY 14228 Erie 7166910639

Jaffri, Syed S. Psychiatry Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621759

Jaffri, Syed S. Psychiatry Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476142

Jones, Leeland A. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Jones, Leeland A. Psychiatry Jones, Leeland 2nd Fl Ste 7 3871 Harlem Rd Buffalo NY 14215 Erie 7168367981

Joseph, Brian Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Joseph, Brian Psychiatry Joseph, Brian 5820 Main St Ste 206 Williamsville NY 14221 Erie 7166335997

Kang, Balvindar S. Psychiatry Kang, Balvindar 3802 Seneca St Buffalo NY 14224 Erie 7166774240

Kashin, Jeffrey D. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591675

Kashin, Jeffrey D. Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Kashin, Jeffrey D. Psychiatry Kaleida Health 80 Goodrich St Buffalo NY 14203 Erie 7168592133

Kaye, David L. Psychiatry Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168875800

Kaye, David L. Psychiatry University Psychiatric Practice Inc 3 Gates Cir 8th Flr Buffalo NY 14209 Erie 7168875800

Kaye, David L. Psychiatry University Psychiatric Practice Inc 3 Gates Cir 8th Flr Buffalo NY 14209 Erie 7168875800

Kaye, David L. Psychiatry University Psychiatric Practice Inc 1028 Main St Buffalo NY 14202 Erie 7168595454

Kaye, David L. Psychiatry University Psychiatric Practice Inc 1028 Main St Buffalo NY 14202 Erie 7168595454

Khanam, Rashida W. Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Khanam, Rashida W. Psychiatry Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Khanam, Rashida W. Psychiatry Niagara Frontier Psychiatric Assoc 1540 Maple Rd Buffalo NY 14221 Erie 7168390500

Khanam, Rashida W. Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Khanam, Rashida W. Psychiatry Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168222028

Khanam, Rashida W. Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Khanam, Rashida W. Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166481342

Khanam, Rashida W. Psychiatry Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Khanam, Rashida W. Psychiatry Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Khanam, Rashida W. Psychiatry Western New York Medical 4949 Harlem Rd Ste 1 Buffalo NY 14226 Erie 7169234380

Khurana, Pamela Psychiatry Niagara Frontier Psychiatric Assoc C o Phymedco 111 Wales Ave Tonawanda NY 14150 Erie 7166337600

Khurana, Pamela Psychiatry Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168282055

Khurana, Pamela Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Ko, Hak J. Psychiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482202

Ko, Hak J. Psychiatry Ko, Hak 5687 Main St Ste 102 Buffalo NY 14221 Erie 7162043541

Konakanchi, Ramesh Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Konakanchi, Ramesh Psychiatry Suburban Psychiatric Assoc 240 Red Tail Ste 7 and 8 Orchard Park NY 14127 Erie 7166893333

Konakanchi, Ramesh Psychiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482180

Konakanchi, Ramesh Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Konakanchi, Ramesh Psychiatry Konakanchi, Ramesh 4184 Seneca St Ste 208 Buffalo NY 14224 Erie 7165593021

Konakanchi, Ramesh Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591675

Konakanchi, Ramesh Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Konakanchi, Ramesh Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166481342

Konakanchi, Ramesh Psychiatry Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Konakanchi, Ramesh Psychiatry Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Konakanchi, Ramesh Psychiatry Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168222028

Konakanchi, Ramesh Psychiatry Western New York Medical 4949 Harlem Rd Ste 1 Buffalo NY 14226 Erie 7169234380

Konakanchi, Ramesh Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Kothari, Khyati N. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984857

Kreeger, Joy L. Psychiatry Kreeger, Joy L. 484 Main St East Aurora NY 14052 Erie 7168051717

Kreeger, Joy L. Psychiatry Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Laha, Sarojini Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Leo, Raphael Psychiatry Seneca Health Care Center 2987 Seneca St West Seneca NY 14224 Erie 7168280500

Leo, Raphael Psychiatry Kaleida Health 80 Goodrich St Buffalo NY 14203 Erie 7168591675

Leo, Raphael Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168984857

Leo, Raphael Psychiatry Kaleida Health 3 Gates Cir Buffalo NY 14209 Erie 7168984857

Leo, Raphael Psychiatry University Psychiatric Practice Inc 1400 Sweethome Rd Ste 4 Buffalo NY 14228 Erie 7166884180

Page 120 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Leo, Raphael Psychiatry Autumn View Health Care Facility LLC S4650 Southwestern Blvd Hamburg NY 14075 Erie 7166482450

Leo, Raphael Psychiatry Garden Gate Manor 2365 Union Rd Cheektowaga NY 14227 Erie 7168262010

Leo, Raphael Psychiatry Harris Hill Nursing Facility 2699 Wehrle Dr Williamsville NY 14221 Erie 7166323700

Levy, Harold J. Psychiatry Levy, Harold 2740 Main St Buffalo NY 14214 Erie 7168373990

Lim, Christine C. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Lopez, Oscar S. Psychiatry Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Lopez, Oscar S. Psychiatry St Joseph Hospital 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912423

Lopez, Oscar S. Psychiatry Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Lopez, Oscar S. Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Marshall Hobika, Dori Psychiatry University Psychiatric Practice Inc 462 Grider St 1168 Buffalo NY 14215 Erie 7168984857

Martin, Christopher G. Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Martin, Christopher G. Psychiatry Kenmore Mercy Hospital 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Martin, Christopher G. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592589

Martin, Christopher G. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Martin, Christopher G. Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Mikowski, Annemarie L. Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168351246

Mirza, Madiha A. Psychiatry Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482105

Mirza, Madiha A. Psychiatry Madiha A Mirza MD PC 18 Limestone Dr Ste 10 Williamsville NY 14221 Erie 7166330057

Misir, Devinalini Psychiatry University Psychiatric Practice Inc 462 Grider St 1168 Buffalo NY 14215 Erie 7168983465

Mogerman, Michael S. Psychiatry Northtowns Psychiatry, P.C. 479 Englewood Ave Tonawanda NY 14223 Erie 7168319030

Mostert, Marcelle A. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168987815

Mutton, Holly B. Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Ste 130 Amherst NY 14226 Erie 7168351246

Mutton, Holly B. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Nagra, Balwant S. Psychiatry University Psychiatric Practice Inc 462 Grider St Buffalo NY 14215 Erie 7168983462

Nickolova, Maria Psychiatry Kaleida Health 85 Bryant Woods S Buffalo NY 14228 Erie 7166893333

Nickolova, Maria Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Oliveira, Maria L. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Oliveira, Maria L. Psychiatry Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Park, Seung Kyoon Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984884

Park, Wonhoon Psychiatry University Psychiatric Practice Inc 1010 Main St Buffalo NY 14202 Erie 7168594706

Park, Wonhoon Psychiatry Park, Wonhoon 80 Goodrich St Buffalo NY 14203 Erie 7168592931

Pataki, Agnes G. Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168984536

Phillips, Rebecca S. Psychiatry Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Phillips, Rebecca S. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Piver, Kenneth S. Psychiatry Kenneth S Piver, MD LLC 897 Delaware Ave Ste 101 Buffalo NY 14209 Erie 7168814646

Pristach, Cynthia A. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168983169

Quinlan, Kathleen M. Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168983465

Raghu, Bellamkonda S. Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Buffalo NY 14226 Erie 7168390500

Raghu, Bellamkonda S. Psychiatry Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Raghu, Bellamkonda S. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Raghu, Bellamkonda S. Psychiatry Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Raghu, Bellamkonda S. Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Rahman, Muhammad S. Psychiatry Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Rahman, Muhammad S. Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Rahman, Muhammad S. Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Rahman, Muhammad S. Psychiatry Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Rahman, Muhammad S. Psychiatry Buffalo Emergency Associates 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476596

Rahman, Muhammad S. Psychiatry Western New York Medical 4979 Harlem Rd Ste 1 Buffalo NY 14226 Erie 7169234380

Rahman, Muhammad S. Psychiatry Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rahman, Muhammad S. Psychiatry St Joseph Hospital 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912421

Rahman, Muhammad S. Psychiatry Kaleida Health PO Box 8000 Dept 164 Buffalo NY 14267 Erie 7166923302

Rahman, Muhammad S. Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166481342

Rahman, Muhammad S. Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Rahman, Muhammad S. Psychiatry Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168222028

Reichert, Andrew R. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Ruggieri, Matthew L. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Ruggieri, Matthew L. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984857

Rutigliano, Emilia A. Psychiatry Hashim, Junaid 1825 Maple Rd Ste 200 Williamsville NY 14221 Erie 7168865493

Rutigliano, Emilia A. Psychiatry Bry Lin Hospital Inc 1263 Delaware Ave Buffalo NY 14209 Erie 7168868200

Rutigliano, Emilia A. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Saeed, Mohammad A. Psychiatry Western New York Medical 4979 Harlem Rd Ste 1 Buffalo NY 14226 Erie 7169234380

Saeed, Mohammad A. Psychiatry Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Saeed, Mohammad A. Psychiatry Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Saeed, Mohammad A. Psychiatry Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166481342

Saeed, Mohammad A. Psychiatry Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168222028

Saeed, Mohammad A. Psychiatry Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Page 121 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Saeed, Mohammad A. Psychiatry Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Saeed, Mohammad A. Psychiatry Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Samie, Mohammad R. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Schaeffer, Rebecca L. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984857

Schwartz, Irina Psychiatry 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Schwartz, Irina Psychiatry Buffalo Psychiatry PC 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Sengupta, Sourav Psychiatry University Psychiatric Practice Inc 462 Grider St Ste 1168 Buffalo NY 14215 Erie 7168984857

Sengupta, Sourav Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Ste 130 Amherst NY 14226 Erie 7168351246

Sengupta, Sourav Psychiatry CHC of Buffalo INC 34 Benwood Ave Buffalo NY 14214 Erie 7169869199

Shamsi, Syed A. Psychiatry Jamestown Psychiatric PC 2625 Harlem Rd Ste 160 Buffalo NY 14225 Erie 7164832603

Silvestri, Nicholas J. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Singh, Joshna Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Singh, Joshna Psychiatry University Psychiatric Practice Inc 4955 N Bailey Ave Ste 130 Amherst NY 14226 Erie 7168351246

Singh, Joshna Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984857

Spirin, Semen S. Psychiatry University Psychiatric Practice Inc 462 Grider St Buffalo NY 14215 Erie 7168984884

Spirin, Semen S. Psychiatry Jamestown Psychiatric PC 7020 Erie Rd Derby NY 14047 Erie 7165264041

Spirin, Semen S. Psychiatry Jamestown Psychiatric PC 2625 Harlem Rd Ste 160 Buffalo NY 14225 Erie 7164832603

Syed, Abdul H. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984536

Tan III, Alfonso R. Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984536

Warren, Calvert G. Psychiatry University Psychiatric Practice Inc 462 Grider St 11th Fl Buffalo NY 14215 Erie 7168983462

Weinstein, Wendy L. Psychiatry Weinstein, Wendy 651 Delware Ave Ste 201 Buffalo NY 14202 Erie 7163621210

Willis, Daniel J. Psychiatry Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Willis, Daniel J. Psychiatry Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Withiam Leitch, Sherry A. Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168348200

Xu, Junzhe Psychiatry VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Yu, Hong Psychiatry University Psychiatric Practice Inc 462 Grider St Rm 1168 Buffalo NY 14215 Erie 7168984536

Aidala, Linda C. Psychology Aidala, Linda 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Alabiso, Frank P. Psychology Suburban Psychiatric Assoc 85 Bryant Woods S Buffalo NY 14228 Erie 7166893333

Alessi, Susan I. Psychology Alessi, Susan 703 W Ferry St Apt 15 Buffalo NY 14222 Erie 7168812472

Anderson, Laura M. Psychology Laurie Marie Anderson 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Anderson, Stephen R. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Anderson, Stephen R. Psychology Summit Educational Resources 4535 Southwestern Blvd Ste 707 Hamburg NY 14075 Erie 7166293400

Anderson, Stephen R. Psychology Summit Educational Resources 415 N French Amherst NY 14228 Erie 7166293400

Andrews, Ted J. Psychology CHE Senior Psychological Service 1014 Delaware Ave Buffalo NY 14209 Erie 7168836782

Andrews, Ted J. Psychology Andrews, Ted J 112 Bondcroft Dr Amherst NY 14226 Erie 7164804673

Andrews, Ted J. Psychology CHE Senior Psychological Service 3509 Ramsomwille Rd Buffalo NY 14209 Erie 8002753243

Andrews, Ted J. Psychology CHE Senior Psychological Service 292 Main St East Aurora NY 14052 Erie 8002753243

Atkinson, Alan C. Psychology Alan C Atkinson PHD Psychologist PC 5784 Main St Williamsville NY 14221 Erie 7166336863

Atkinson, Alan C. Psychology Nancy Martina 5784 Main St Williamsville NY 14221 Erie 7166336863

Baker, John G. Psychology Baker, John 105 Parker Hall 3435 Main St Buffalo NY 14214 Erie 7168385889

Bartlett, Donald P. Psychology UB Family Medicine Inc 1315 Jefferson Ave Buffalo NY 14208 Erie 7163323797

Bartlett, Donald P. Psychology UB Family Medicine Inc 2465 Sheridan Dr Tonawanda NY 14150 Erie 7168359800

Bartnik, Caryn A. Psychology Bartnik, Caryn 2430 Bowen Rd Elma NY 14059 Erie 7163160577

Baskin, Renee M. Psychology Baskin, Renee M. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Benedict, Ralph H. Psychology University Psychiatric Practice Inc 462 Grider St Buffalo NY 14215 Erie 7168984535

Benedict, Ralph H. Psychology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Benjamins, John K. Psychology John K Benjamins PhD 4390 Quinby Dr Ste F Hamburg NY 14075 Erie 7166485700

Bernstein, Gary L. Psychology Bernstein, Gary 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Bleichfeld, Bruce Psychology Bleichfeld, Bruce 5820 Main St Ste 402 Williamsville NY 14221 Erie 7166331550

Bongiovanni, Anthony F. Psychology Bongiovanni, Anthony 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Bowen, Tanya S. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Briggs, Sally J. Psychology Western New York Behavioral Medicine Andpsychotherapies 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Briggs, Sally J. Psychology Briggs, Sally 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Brooks, James D. Psychology CHE Senior Psychological Service 3509 Ransomville Rd Buffalo NY 14209 Erie 8002753243

Brothwell, Lisa M. Psychology Brothwell, Lisa 552 Linden Ave East Aurora NY 14052 Erie 7166528100

Bundy Myrow, Susan J. Psychology Bundy-Myrow, Susan 822 Center Rd Buffalo NY 14224 Erie 7166756702

Burrows MacLean, Lisa D. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Burrows MacLean, Lisa D. Psychology Burrows-MacLean, Lisa D. 5820 Main St Ste 402 Williamsville NY 14221 Erie 7163352209

Burrows MacLean, Lisa D. Psychology Summit Educational Resources 415 N French Rd Amherst NY 14228 Erie 7166293400

Burrows, Ronald L. Psychology Burrows, Ronald 5680 Main St Ste 402 Buffalo NY 14221 Erie 7166315039

Butters, James Psychology Butters, James 37 S Cayuga Rd Williamsville NY 14221 Erie 7166267492

Carter, Cathleen Psychology Carter, Cathleen 703 W Ferry St Buffalo NY 14222 Erie 7168863389

Casey, William M. Psychology Casey, William 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Cebollero, Alberto R. Psychology CHE Senior Psychological Service 10570 Bergtold Rd Clarence NY 14031 Erie 8002753243

Cebollero, Alberto R. Psychology CHE Senior Psychological Service 200 7th St Buffalo NY 14201 Erie 8002753243

Cebollero, Alberto R. Psychology CHE Senior Psychological Service 4520 Ransom Rd Clarence NY 14031 Erie 8002753243

Page 122 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Cebollero, Alberto R. Psychology CHE Senior Psychological Service 5951 Broadway Lancaster NY 14086 Erie 8002753243

Cebollero, Alberto R. Psychology CHE Senior Psychological Service 5949 Broadway Ave Lancaster NY 14086 Erie 8002753243

Cercone, Kristen A. Psychology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Chenelly, Drew Psychology Avallon Behavioral Health 121 N Main St Ste 310 North Collins NY 14111 Erie 5855895076

Chesnutt, Karen W. Psychology Chesnutt, Karen 5820 Main St Ste 610 Williamsville NY 14221 Erie 7166335782

Chrystal Jr, Charles A. Psychology Chrystal, Charles 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Chugh, Cary S. Psychology Chugh, Cary 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Cook Cottone, Catherine P. Psychology Cook-Cottone, Catherine 4476 Main St Ste 205 Snyder NY 14226 Erie 7164405597

Cottone, Jerry W. Psychology Jerry Cottone 4476 Main St Ste 205 Amherst NY 14226 Erie 7168617820

Crans Stafford, Amy Jo Psychology Crans-Stafford, Amy Jo 5500 Main St Ste 308 Williamsville NY 14221 Erie 7166341184

Cronin, Noreen N. Psychology Cronin, Noreen 817 Abbott Rd Buffalo NY 14220 Erie 7168278274

D'Arrigo, Mary C. Psychology CHE Senior Psychological Service 200 Bassett Rd Williamsville NY 14221 Erie 8002753243

D'Arrigo, Mary C. Psychology D'Arrigo, Mary 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

D'Arrigo, Mary C. Psychology CHE Senior Psychological Service 111 St Gregory Ct Williamsville NY 14221 Erie 8002753243

D'Arrigo, Mary C. Psychology CHE Senior Psychological Service 245 Basset Rd Buffalo NY 14221 Erie 8002753243

D'Arrigo, Mary C. Psychology CHE Senior Psychological Service 2850 Grand Island Blvd Grand Island NY 14072 Erie 8002753243

D'Arrigo, Mary C. Psychology CHE Senior Psychological Service 225 Bennett Rd Buffalo NY 14227 Erie 8002753243

D'Arrigo, Mary C. Psychology CHE Senior Psychological Service 1818 Como Park Blvd Lancaster NY 14086 Erie 8002753243

Deeb, Jodi S. Psychology Niagara Frontier Psychiatric Assoc C o Phymedco 111 Wales Ave Tonawanda NY 14150 Erie 7166337600

Deeb, Jodi S. Psychology Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Deeb, Jodi S. Psychology Deeb, Jodi 1967 Wehrle Rd St 1 Williamsville NY 14221 Erie 7162615565

Demerath, Robert Psychology Demerath, Robert 388 Evans St Ste 303 Buffalo NY 14221 Erie 7166322335

Descutner, Carol J. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 3158349200

Descutner, Carol J. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Descutner, Carol J. Psychology Descutner, Carol J. 1967 WEHRLE DR Ste 1 Williamsville NY 14221 Erie 7162502717

Donofrio, Ilene A. Psychology Donofrio, Ilene 5500 Main St Ste 308 Buffalo NY 14221 Erie 7166261245

Donovan, Sheila M. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Duffy, Kevin P. Psychology Duffy, Kevin 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Duffy, Kevin P. Psychology Buffalo Psychology Group 290 Woodward Ave Buffalo NY 14214 Erie 7168336084

Engl, Lorraine M. Psychology Engl, Lorraine 37 S Cayuga Rd Williamsville NY 14221 Erie 7166267492

Engl, Lorraine M. Psychology Engl, Lorraine 37 S Cayuga Rd Buffalo NY 14221 Erie 7166267492

Erkkila, Helen E. Psychology Erkkila, Helen 5500 Main St Ste 207 Buffalo NY 14221 Erie 7166336900

Evans, Carol S. Psychology Evans, Carol 3950 E Robinson Rd West Amherst NY 14228 Erie 7166913400

Evans, Carol S. Psychology Evans, Carol 37 S Cayuga Rd Buffalo NY 14221 Erie 7166267492

Fabiano, Gregory A. Psychology Gregory A Fabiano 4476 Main St Ste 205 Amherst NY 14226 Erie 7169827781

Farrell, Megan M. Psychology Farrell, Megan 377 Main St Upper East Aurora NY 14052 Erie 7168057995

Farrow, Sherry M. Psychology Sherry M Farrow 8160 Wehrle Dr Williamsville NY 14221 Erie 7162075665

Fendya, Jennifer A. Psychology Fendya, Jennifer 408 Franklin St Buffalo NY 14202 Erie 8889029614

Fendya, Jennifer A. Psychology Fendya, Jennifer 155 Summer Street Buffalo NY 14222 Erie 8889029614

Fendya, Jennifer A. Psychology Fendya, Jennifer 484 Main St East Aurora NY 14052 Erie 8889029614

Fischer, John C. Psychology Dr John C Fischer Psychologist Pc 4511 Harlem Rd Ste 2 Buffalo NY 14226 Erie 7168390740

Fischer, John C. Psychology Dr John C Fischer Psychologist Pc 252 Main St Springville NY 14141 Erie 7165929292

Ford, Krista A. Psychology Ford, Krista A. 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Gallacher, Fiona P. Psychology Gallacher, Fiona 21 Linwood Ave Williamsville NY 14221 Erie 7166269016

Gilles Thomas, Anne E. Psychology Gilles-Thomas, Anne 1961 Wehrle Dr Ste 11 Williamsville NY 14221 Erie 7169490906

Graham, Robert J. Psychology Graham, Robert J. 36 Dorchester Rd Buffalo NY 14222 Erie 7168821190

Griffin, Michael D. Psychology Griffin, Michael D. 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Grover, Sumit K. Psychology Grovers Psychological and Counseling Professional Corp 8600 Sheridan Dr Williamsville NY 14221 Erie 7165786963

Gunther, Mark W. Psychology Gunther, Mark 462 Grider St Rm 943 Buffalo NY 14215 Erie 7168983955

Habberfield, Tedd Psychology Habberfield, Tedd 37 S Cayuga Rd Buffalo NY 14221 Erie 7166267492

Hamilton, Jill E. Psychology Aspire of WNY Inc 7 Community Dr Cheektowaga NY 14225 Erie 7165055630

Harrison, Michael H. Psychology Michael H Harrison 3085 Southwestwern Blvd Ste 107 Orchard Park NY 14127 Erie 7166741500

Harrison, Robin K. Psychology Michael H Harrison 3085 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166741500

Hitzel, Howard K. Psychology Hitzel, Howard 229 Main St Hamburg NY 14075 Erie 7163168774

Honer, Kathleen B. Psychology Summit Educational Resources 415 N French Amherst NY 14228 Erie 7166293400

Honer, Kathleen B. Psychology Summit Educational Resources 4535 Southwestern Blvd Ste 707 Hamburg NY 14075 Erie 7166293400

Honer, Kathleen B. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Ippolito, Janine M. Psychology Janine M Ippolito 4053 Maple Rd Ste 110 Amherst NY 14226 Erie 7165786963

Ippolito, Janine M. Psychology Janine M Ippolito 8600 Sheridan Dr Williamsville NY 14221 Erie 7165786963

Jablonski, Amy L. Psychology Summit Educational Resources 4535 Southwestern Blvd Ste 707 Hamburg NY 14075 Erie 7166293400

Jablonski, Amy L. Psychology Summit Educational Resources 415 N French Amherst NY 14228 Erie 7166293400

Jablonski, Amy L. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Jackson, Lisa A. Psychology Lisa A Jackson, PhD 4955 N Bailey Ave Ste 208 Amherst NY 14226 Erie 7168330292

Jacobs, Edith Psychology Jacobs, Edith 406 Linwood Ave Buffalo NY 14209 Erie 7168867304

Janicki, Paula I. Psychology Janicki, Paula 5500 Main St Ste 308 Williamsville NY 14221 Erie 7166341184

Jaworski, Theresa M. Psychology Theresa M Jaworski PhD 6507 Transit Rd Ste B East Amherst NY 14051 Erie 7162040100

Page 123 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Keenan, Lisa A. Psychology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Keller, Christopher J. Psychology Faye E Taber Nurse Practitioner In Psychiatry PLLC 5820 Main St Ste 500 Buffalo NY 14221 Erie 7166342538

Keller, Christopher J. Psychology Hashim, Junaid 1825 Maple Rd Ste 200 Williamsville NY 14221 Erie 7168865493

Keller, Warren D. Psychology Keller, Warren 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Klein, Susan T. Psychology Klein, Susan 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Koenigsberg, Marlon R. Psychology UB Family Medicine Inc 850 Hopkins Rd Williamsville NY 14221 Erie 7166889641

Kopfer, Paul M. Psychology Kopfer, Paul 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Krasner, Susan S. Psychology Krasner, Susan 462 Grider St DK Miller Bldg Buffalo NY 14215 Erie 7168985672

Krasner, Susan S. Psychology Krasner, Susan 6507 Transit Rd Ste B East Amherst NY 14051 Erie 7162040100

Kweller, Rion B. Psychology Kweller, Rion 6000 N Bailey Ave Ste 1d Amherst NY 14226 Erie 7168344266

Kweller, Rion B. Psychology Kweller, Rion 5500 Main St Ste 308 Williamsville NY 14221 Erie 7166341184

Lackner, Jeffrey M. Psychology Academic Medicine Services 462 Grider St Buffalo NY 14240 Erie 7168983000

Lackner, Jeffrey M. Psychology Lackner, Jeffrey 462 Grider St Buffalo NY 14215 Erie 7168985671

Lanze, Mark C. Psychology Lanze, Mark 8265 Sheridan Dr Williamsville NY 14221 Erie 7166346757

Mazur, Thomas A. Psychology Mazur, Tom 219 Bryant St Buffalo NY 14222 Erie 7168787815

McClintock, Karen L. Psychology McClintock, Karen 3959 N Buffalo Rd Orchard Park NY 14127 Erie 7166676331

McCourt, Bernadette C. Psychology McCourt, Bernadette 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

McDonnell, Betsy Psychology CHE Senior Psychological Service 1503 Military Buffalo NY 14217 Erie 8002753243

McDonnell, Betsy Psychology CHE Senior Psychological Service 76 Buffalo St Hamburg NY 14075 Erie 8002753243

McDonnell, Betsy Psychology CHE Senior Psychological Service 307 Porter Ave Buffalo NY 14201 Erie 8008753243

McDonnell, Betsy Psychology CHE Senior Psychological Service 2806 George St Eden NY 14057 Erie 8002753243

McDonnell, Betsy Psychology CHE Senior Psychological Service 300 Dorrance Ave Buffalo NY 14220 Erie 8002753243

Meichenbaum, David L. Psychology Summit Educational Resources 415 N French Amherst NY 14228 Erie 7166293400

Meichenbaum, David L. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Meichenbaum, David L. Psychology Summit Educational Resources 4535 Southwestern Blvd Ste 707 Hamburg NY 14075 Erie 7166293400

Messer, Drew C. Psychology Electronic Gaming Therapy 8616 Main St Ste 4 Williamsville NY 14221 Erie 7169619435

Miello, Michael J. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Mignone Klostermann, Theresa Psychology Theresa Mignone-Klostermann 4511 Harlem Rd Snyder NY 14226 Erie 7163455383

Mignone Klostermann, Theresa Psychology CHE Senior Psychological Service 2235 Millersport Hwy Getzville NY 14068 Erie 8002753243

Minkoff, Robert A. Psychology Minkoff, Robert 315 Alberta Dr Ste 211 Buffalo NY 14226 Erie 7168376705

Mirwis, Joshua E. Psychology Joshua E Mirwis 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Moses, Michael Psychology Moses, Michael 408 Franklin St Buffalo NY 14202 Erie 7166950008

Moses, Michael Psychology Moses, Michael 5500 Main St Williamsville NY 14221 Erie 7166950008

Moses, Nichol A. Psychology 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Moyer, Brian H. Psychology Brian H Moyer 8616 Main St Ste 4 Williamsville NY 14221 Erie 7169619435

Myrow, David L. Psychology Myrow, David 822 Center Rd West Seneca NY 14224 Erie 7166756702

Namaste, Karen G. Psychology Namaste, Karen 5500 Main St Ste 207 Buffalo NY 14221 Erie 7166336900

Nash, Linda B. Psychology Linda B Nash PhD 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Naylor, Justin A. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Naylor, Justin A. Psychology Summit Educational Resources 165 Creekside Dr Amherst NY 14228 Erie 7168107700

Naylor, Justin A. Psychology Summit Educational Resources 415 N French Rd Amherst NY 14228 Erie 7166293141

Naylor, Justin A. Psychology Summit Educational Resources 4535 Southwestern Blvd Ste 707 Hamburg NY 14075 Erie 7166293400

Naylor, Justin A. Psychology Justin A Naylor 19 Hopkins Rd Williamsville NY 14221 Erie 7165318050

Nesser, James A. Psychology CHE Senior Psychological Service 2799 Sheridan Dr Tonawanda NY 14120 Erie 7168374466

Nesser, James A. Psychology CHE Senior Psychological Service 64 Hager St Buffalo NY 14208 Erie 7168864377

Norman, Sally A. Psychology Norman, Sally 6265 Sheridan Dr Ste 122 Williamsville NY 14221 Erie 7162045552

Norman, Sally A. Psychology Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Northman, John E. Psychology Northman, John 4955 N Bailey Ave Buffalo NY 14226 Erie 7168335930

O Connor, Lynn M. Psychology O'Connor, Lynn 3959 N Buffalo Rd Orchard Park NY 14127 Erie 7166676331

O Gorman, Joseph C. Psychology O'Gorman, Joseph 3802 Seneca St West Seneca NY 14224 Erie 7166775418

Pace, Bruce J. Psychology Pace, Bruce 315 Alberta Dr Ste 211 Buffalo NY 14226 Erie 7168376705

Pace, Bruce J. Psychology Pace, Bruce 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Parrack, Jennifer Psychology CHE Senior Psychological Service 5949 Broadway Ave Lancaster NY 14086 Erie 7166843000

Parrack, Jennifer Psychology Parrack, Jennifer 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Parrack, Jennifer Psychology CHE Senior Psychological Service 292 Main St East Aurora NY 14052 Erie 8002753243

Parrack, Jennifer Psychology CHE Senior Psychological Service 168 W Main St Springville NY 14141 Erie 8002753243

Parrack, Jennifer Psychology CHE Senior Psychological Service 222 E Main St Springville NY 14141 Erie 7165922870

Parrack, Jennifer Psychology CHE Senior Psychological Service 1503 Military Rd Kenmore NY 14217 Erie 8002753243

Parrack, Jennifer Psychology CHE Senior Psychological Service 2987 Seneca St West Seneca NY 14224 Erie 8002753243

Parrack, Jennifer Psychology CHE Senior Psychological Service 5951 Broadway Lancaster NY 14086 Erie 7168280500

Perry, Lorraine J. Psychology 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Pierson, Charles D. Psychology Pierson, Charles 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Pikoff Mirwis, Emily Psychology CHE Senior Psychological Service 5949 Broadway Ave Lancaster NY 14086 Erie 8002753243

Pikoff Mirwis, Emily Psychology CHE Senior Psychological Service 200 7th St Buffalo NY 14201 Erie 8002753243

Pino, Christopher J. Psychology Pino, Christopher 796 Niagara Falls Blvd Buffalo NY 14221 Erie 7168320010

Pratt, David M. Psychology Pratt, David M. 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Page 124 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Pratt, David M. Psychology Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Reinhold, Sandra L. Psychology Reinhold, Sandra L. 5784 Main St Williamsville NY 14221 Erie 7166333863

Ricotta, Philip F. Psychology Ricotta, Philip 1404 Sweethome Rd Ste 2 Amherst NY 14228 Erie 7166340566

Roach, Jeffrey P. Psychology Roach, Jeffrey 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Ross, Daniel A. Psychology Ross, Daniel 5820 Main St Ste 204 Buffalo NY 14221 Erie 7166496145

Rousselle, Ann Psychology Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Rowland, Sarah A. Psychology Rowland, Sarah A. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Ruben, Cherie B. Psychology Community Concern of WNY Inc 6722 Erie Rd Derby NY 14047 Erie 7169475025

Rubin, Mary Ellen Y. Psychology Rubin, Mary Ellen 6265 Sheridan Dr Ste 116 Williamsville NY 14221 Erie 7166325563

Russo, Angel M. Psychology Russo, Angel 6541 Webster Rd Orchard Park NY 14127 Erie 7166677031

Russo, Angel M. Psychology Russo, Angel 5820 Main St Ste 400 Williamsville NY 14222 Erie 7166677031

Rutter, Michael E. Psychology Rutter, Michael 37 S Cayuga Rd Williamsville NY 14221 Erie 7166267492

Sanborn, Kathryn J. Psychology Sanborn, Kathryn 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Santarpia, Susan M. Psychology Susan M Santarpia 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Schachter, Mark Psychology Schachter, Mark 388 Evans St Williamsville NY 14221 Erie 7166330103

Shanley, Stephen W. Psychology Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Shanley, Stephen W. Psychology Church Mission Of Help Inc 153 W Utica St Buffalo NY 14222 Erie 7168847569

Shefrin, Russell N. Psychology Shefrin, Russell 3065 Southwestern Blvd Ste 204 Orchard Park NY 14127 Erie 7166759232

Shefrin, Russell N. Psychology Shefrin, Russell 315 Alberta Dr Ste 211 Amherst NY 14226 Erie 7168376705

Shucard, Janet L. Psychology Univ Neurology Inc 3435 Main St Buffalo NY 14214 Erie 7168292099

Shuman, Amy L. Psychology Shuman, Amy L. 884 Brighton Rd Tonawanda NY 14150 Erie 7168369460

Skiffington, Stephen T. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Skiffington, Stephen T. Psychology Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Buffalo NY 14226 Erie 7168390500

Slater, Judith F. Psychology Slater, Judith 5500 Main St Buffalo NY 14221 Erie 7166336900

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 147 Reist St Buffalo NY 14221 Erie 8002753243

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 2799 Sheridan Dr Tonawanda NY 14150 Erie 8008753243

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 5775 Maelou Dr Hamburg NY 14075 Erie 7166482820

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 34 Benwood Ave Buffalo NY 14214 Erie 8008753243

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 2699 Wehrle Dr Williamsville NY 14221 Erie 8008753243

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 2235 Millersport Hwy Getzville NY 14068 Erie 8008753243

Sokoloff, Mark J. Psychology CHE Senior Psychological Service 3333 Elmwood Ave Kenmore NY 14217 Erie 8008753243

Steck Silvestri, Erin L. Psychology Steck Silvestri, Erin L. 4476 Main St Ste 205 Amherst NY 14226 Erie 7167680928

Sturniolo Jr, Frank M. Psychology Sturniolo, Frank 796 Niagara Falls Blvd Buffalo NY 14223 Erie 7168321434

Taublieb, Amy Beth Psychology Taublieb, Amy Beth 1006 Niagara Falls Blvd Tonawanda NY 14150 Erie 7168341505

Terry, Danielle L. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Thomas, Sherilyn N. Psychology Thomas, Sherilyn 5500 Main St Ste 207 Williamsville NY 14221 Erie 7166336400

Toner, Kathleen Psychology Suburban Psychiatric Assoc 85 Bryant Woods S Amherst NY 14228 Erie 7166893333

Toomey Starr, Jennifer A. Psychology Summit Educational Resources 150 Stahl Rd Getzville NY 14068 Erie 7166293400

Toomey Starr, Jennifer A. Psychology Summit Educational Resources 415 N French Amherst NY 14228 Erie 7166293400

Totin, Martha J. Psychology Niagara Frontier Psychiatric Assoc 507 Crescent Ave Buffalo NY 14214 Erie 7168361076

Totin, Martha J. Psychology 4511 Harlem Rd Snyder NY 14226 Erie 7166974720

Totin, Martha J. Psychology Niagara Frontier Psychiatric Assoc 4985 Harlem Rd Amherst NY 14226 Erie 7168390500

Treible, Jonathan L. Psychology Jonathan L Treible 719 Englewood Ave Buffalo NY 14223 Erie 7164801997

Tyrrell, Diane S. Psychology Tyrrell, Diane 5500 Main St Ste 207 Williamsville NY 14221 Erie 7166336900

Unger, Thomas E. Psychology Buffalo Psychology Group 290 Woodward Ave Buffalo NY 14214 Erie 7168336084

Unger, Thomas E. Psychology Buffalo Psychology Group 336 Harris Hill Rd Williamsville NY 14221 Erie 7168336084

Unger, Thomas E. Psychology Buffalo Psychology Group 3623 Eggert Rd Orchard Park NY 14127 Erie 7168336084

Vujnovic, Rebecca K. Psychology 4476 Main St Ste 205 Snyder NY 14226 Erie 7165252192

Wahlig, Elizabeth L. Psychology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Watson, Diana G. Psychology Suburban Psychiatric Assoc 4535 Southwestern Blvd Bldg 700 Ste 701 Hamburg NY 14075 Erie 7166893333

Welchoff, Tracy N. Psychology Welchoff, Tracy 2430 N Forest Rd Ste 140 Amherst NY 14228 Erie 7163168416

Wert, Renee C. Psychology Wert, Renee 406 Linwood Ave Buffalo NY 14209 Erie 7168867304

Whitehouse, Amanda R. Psychology Whitehouse, Amanda R. 21 Princeton Pl Ste 100 Orchard Park NY 14127 Erie 7165399232

Woodruff, Daniel S. Psychology Horton Counseling Center 224 E Main St Springville NY 14141 Erie 5854725738

Zborowski, Michael J. Psychology Zborowski, Michael 5820 Main St Ste 400 Williamsville NY 14221 Erie 7166320034

Zoeller, Nancy L. Psychology Zoeller, Nancy 9750 Transit Rd East Amherst NY 14051 Erie 7166361375

Noe, Michael F. Public & General Prevent Academic Medicine Services Geratric Division Deaconess Cnt 1001 Humboldt Pkwy Buffalo NY 14208 Erie 7168878200

Noe, Michael F. Public & General Prevent Academic Medicine Services 3 Gates Cir Buffalo NY 14209 Erie 7168874690

Noe, Michael F. Public & General Prevent Academic Medicine Services Waterfront Snf 200 Seventh St Buffalo NY 14201 Erie 7168472500

Voian, Nicoleta C. Public & General Prevent Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Alraiyes, Abdul Hamid Pulmonary Disease Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Aquilina, Alan T. Pulmonary Disease Associated Healthcare Systems Inc 1400 Sweethome Rd Buffalo NY 14228 Erie 7168983199

Aquilina, Alan T. Pulmonary Disease Academic Medicine Services 310 Sterling Dr Ste 110 Orchard Park NY 14127 Erie 7166754002

Aquilina, Alan T. Pulmonary Disease Associated Healthcare Systems Inc 462 Grider St Buffalo NY 14215 Erie 7168983375

Aquilina, Alan T. Pulmonary Disease Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983375

Aquilina, Alan T. Pulmonary Disease Academic Medicine Services 6105 Transit Rd East Amherst NY 140512611 Erie 7163483440

Page 125 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Aquilina, Alan T. Pulmonary Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983333

Aquilina, Alan T. Pulmonary Disease Academic Medicine Services 4893 Transit Rd Depew NY 14043 Erie 7166682543

Aquilina, Alan T. Pulmonary Disease Academic Medicine Services 4511 Harlem Rd Ste 202 Amherst NY 14221 Erie 7169294654

Aquilina, Alan T. Pulmonary Disease Alan Thomas Aquilina MD 6105 Transit Rd East Amherst NY 14051 Erie 7163483435

Augustine, Francis K. Pulmonary Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14224 Erie 7168267000

Boepple, Hartwig O. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Boepple, Hartwig O. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476396

Boepple, Hartwig O. Pulmonary Disease The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

Boepple, Hartwig O. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Buscaglia, Anthony J. Pulmonary Disease Buscaglia, Anthony 5451 Southwestern Blvd Hamburg NY 14075 Erie 7166493638

Buscaglia, Anthony J. Pulmonary Disease Buscaglia, Anthony 565 ABBOTT RD Buffalo NY 14220 Erie 7168240266

Buscaglia, Anthony J. Pulmonary Disease Buscaglia, Anthony 515 Abbott Rd Buffalo NY 14220 Erie 7168240266

Campbell, Lucy A. Pulmonary Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Desai, Ravi K. Pulmonary Disease Ravi K. Desai, MD, P.C. 462 Grider St Buffalo NY 14215 Erie 7168983000

Desai, Ravi K. Pulmonary Disease Ravi K. Desai, MD, P.C. 17 Limestone Dr Ste 3 Williamsville NY 14221 Erie 7168271616

Desai, Ravi K. Pulmonary Disease Ravi K. Desai, MD, P.C. 100 High St Buffalo NY 14203 Erie 7168271616

Desai, Ravi K. Pulmonary Disease Ravi K. Desai, MD, P.C. 565 Abbott Rd Buffalo NY 14220 Erie 7168271616

Desai, Ravi K. Pulmonary Disease Buffalo Emergency Associates 565 Abbott Rd Buffalo NY 14220 Erie 7168282666

Desai, Ravi K. Pulmonary Disease Buffalo Internist & Associates LLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Desai, Ravi K. Pulmonary Disease Ravi K. Desai, MD, P.C. 2157 Main St Buffalo NY 14214 Erie 7168271616

Desai, Ravi K. Pulmonary Disease Ravi K. Desai, MD, P.C. 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Desai, Ravi K. Pulmonary Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Durante, David J. Pulmonary Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14210 Erie 7168267000

Durante, David J. Pulmonary Disease Durante, David 1900 Ridge Rd Ste 130 West Seneca NY 14224 Erie 7166770850

Edelson, Jonathan S. Pulmonary Disease The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

Edelson, Jonathan S. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Edelson, Jonathan S. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Fitzpatrick, James M. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave 2nd FL Kenmore NY 14217 Erie 7168768760

Fitzpatrick, James M. Pulmonary Disease Fitzpatrick, James 2950 Elmwood Ave Kmh 2nd Fl Kenmore NY 14217 Erie 7168768760

Fitzpatrick, James M. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Ste 2034 Kenmore NY 14217 Erie 7164476100

Frederick, Carla A. Pulmonary Disease Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Frederick, Carla A. Pulmonary Disease University at Buffalo Pediatric Associates Inc 219 Bryant St Buffalo NY 14222 Erie 7168787561

Frederick, Carla A. Pulmonary Disease Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Frederick, Carla A. Pulmonary Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Frederick, Carla A. Pulmonary Disease Academic Medicine Services 219 Bryant St Buffalo NY 14222 Erie 7168787000

Frederick, Carla A. Pulmonary Disease Academic Medicine Services Elm and Carlton St Buffalo NY 14263 Erie 7168451523

Frederick, Carla A. Pulmonary Disease Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597280

Freundel, Anthony D. Pulmonary Disease The Pulmonary Grp Of W Ny 2699 Wehrle Dr Buffalo NY 14221 Erie 7166323700

Freundel, Anthony D. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Freundel, Anthony D. Pulmonary Disease The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Buffalo NY 14221 Erie 7166318863

Freundel, Anthony D. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gelfer, Alexander B. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gelfer, Alexander B. Pulmonary Disease The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

Gelfer, Alexander B. Pulmonary Disease St Joseph Hospital 297 Spindrift Dr Ste 100 Williamsville NY 14221 Erie 7166318863

Gelfer, Alexander B. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Gough, Michael S. Pulmonary Disease Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gough, Michael S. Pulmonary Disease Buffalo Internal Medicine PLLC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Gough, Michael S. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave 2nd FL Kenmore NY 14217 Erie 7168768760

Gough, Michael S. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Harris, Kassem N. Pulmonary Disease Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Jaoude, Philippe E. Pulmonary Disease Kaleida Health 100 High St B8 The Heart and Lung Center Buffalo NY 14203 Erie 7168597280

Jaoude, Philippe E. Pulmonary Disease Buffalo Medical Group 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7168578666

Jaoude, Philippe E. Pulmonary Disease VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168592259

Jaoude, Philippe E. Pulmonary Disease Academic Medicine Services 3980 Sheridan Dr 6th Fl Amherst NY 14226 Erie 7168826544

Jaoude, Philippe E. Pulmonary Disease Daniel I Rifkin Md Pc Dba Sleep Medicine C 1120 Youngs Rd Williamsville NY 14221 Erie 7169237326

Jaoude, Philippe E. Pulmonary Disease Daniel I Rifkin Md Pc Dba Sleep Medicine C 4090 Seneca St West Seneca NY 14224 Erie 7169237326

Jaoude, Philippe E. Pulmonary Disease Daniel I Rifkin Md Pc Dba Sleep Medicine C 219 Bryant St Buffalo NY 14222 Erie 7169237326

Jaoude, Philippe E. Pulmonary Disease Academic Medicine Services Elm and Carlton Sts Buffalo NY 14263 Erie 7168451523

Jaoude, Philippe E. Pulmonary Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Jaoude, Philippe E. Pulmonary Disease Daniel I Rifkin Md Pc Dba Sleep Medicine C 1491 Sheridan Dr Kenmore NY 14223 Erie 7169237326

Jaoude, Philippe E. Pulmonary Disease Daniel I Rifkin Md Pc Dba Sleep Medicine C 640 Ellicott St Buffalo NY 14203 Erie 7169237326

Jaoude, Philippe E. Pulmonary Disease Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301000

Jaoude, Philippe E. Pulmonary Disease Buffalo Medical Group 295 Essjay Rd Buffalo NY 14221 Erie 7166301000

Jaoude, Philippe E. Pulmonary Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Jiva, Tajuddin M. Pulmonary Disease Phoenix Rising Medical PC 2545 Sheridan Dr Ste 5 Tonawanda NY 14150 Erie 7168361388

Jiva, Tajuddin M. Pulmonary Disease Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Khan, Mohammad A. Pulmonary Disease Ravi K. Desai, MD, P.C. 462 Grider St Buffalo NY 14215 Erie 7168983000

Khan, Mohammad A. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Khan, Mohammad A. Pulmonary Disease Buffalo Internist & Associates LLC 462 Grider St Buffalo NY 14215 Erie 7168983000

Khan, Mohammad A. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Kufel, Thomas J. Pulmonary Disease VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Lampasso, James G. Pulmonary Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Mador, M Jeffery Pulmonary Disease Academic Medicine Services 6105 Transit Rd Ste 100 East Amherst NY 14051 Erie 7163483435

Mammen, Manoj J. Pulmonary Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Mammen, Manoj J. Pulmonary Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Mammen, Manoj J. Pulmonary Disease Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Mishra, Archana Pulmonary Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Mishra, Archana Pulmonary Disease Kaleida Health 100 High St Ste B 8 Buffalo NY 14203 Erie 7168597280

Mishra, Archana Pulmonary Disease Ravi K. Desai, MD, P.C. 462 Grider St Buffalo NY 14215 Erie 7168983000

Nadler, Jamie N. Pulmonary Disease Kaleida Health 100 High St D 3 Buffalo NY 14203 Erie 7168592524

Nadler, Jamie N. Pulmonary Disease Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168595600

Nadler, Jamie N. Pulmonary Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592260

Nadler, Jamie N. Pulmonary Disease Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597280

Neu, Jeffery R. Pulmonary Disease Buffalo Cardiology and Pulmonary Associates 6460 Main St Williamsville NY 14221 Erie 7166345100

Provost, Karin Pulmonary Disease VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Provost, Karin Pulmonary Disease Academic Medicine Services 3980 Sheridan Dr Ste 601 Amherst NY 14226 Erie 7168826544

Rabadi, Nashat H. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Samad, Iqbal A. Pulmonary Disease Samad, Iqbal 2148 Main St Buffalo NY 14214 Erie 7168359866

Sfeir, Norman J. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Cheektowaga NY 14225 Erie 7162622400

Sfeir, Norman J. Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Sfeir, Norman J. Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Sfeir, Norman J. Pulmonary Disease The Pulmonary Grp Of W Ny 100 College Pkwy Ste 110 Williamsville NY 14221 Erie 7166318863

Sfeir, Norman J. Pulmonary Disease The Pulmonary Grp Of W Ny 2699 Wehrle Dr Buffalo NY 14221 Erie 7166323700

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 4979 Harlem Rd Amherst NY 14226 Erie 7169234380

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 229 Main St Hamburg NY 14075 Erie 7166491342

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 3218 Walden Ave Depew NY 14043 Erie 7166843500

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 1310 French Rd Depew NY 14043 Erie 7166682592

Siddiqi, Attiya M. Pulmonary Disease Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592260

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 15 Northland Ave Buffalo NY 14208 Erie 7168828989

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 6970 Erie Rd Derby NY 14047 Erie 7169479147

Siddiqi, Attiya M. Pulmonary Disease Western New York Medical 154 Cazenovia St Buffalo NY 14210 Erie 7168228028

Ventresca, Edward Pulmonary Disease Niagara Pulmonary & Sleep Medicine PC 5451 Southwestern Blvd Hamburg NY 14075 Erie 7166493638

Ventresca, Edward Pulmonary Disease Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Ventresca, Edward Pulmonary Disease Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Ventresca, Edward Pulmonary Disease Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Vivona, Joan A. Pulmonary Disease Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Baer, James R. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Chen, William C. Radiation Oncology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Chen, William C. Radiation Oncology CCS Oncology PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168109631

Chen, William C. Radiation Oncology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Cuthbert, David A. Radiation Oncology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445500

Duff, Michael Radiation Oncology Western New York Urology Associates LLC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168953815

Duff, Michael Radiation Oncology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Gomez, Jorge A. Radiation Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301018

Gomez, Jorge A. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Gregoritch, Steven J. Radiation Oncology RADSERVE LLC 45 Spindrift Dr Williamsville NY 14221 Erie 7165659999

Gregoritch, Steven J. Radiation Oncology Buffalo Radiation Oncology 495 International Dr Buffalo NY 14221 Erie 7165653999

Gregoritch, Steven J. Radiation Oncology Southtowns Radiation Oncology 550 Orchard Park Rd Ste A100 West Seneca NY 14224 Erie 7166746800

Gregoritch, Steven J. Radiation Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301175

Gregoritch, Steven J. Radiation Oncology RADSERVE LLC 495 International Dr Williamsville NY 14221 Erie 7165653999

Gregoritch, Steven J. Radiation Oncology Southtowns Radiation Oncology 495 International Dr Williamsville NY 14221 Erie 7165653999

Hare, Gregory B. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Khalil, Moneer Radiation Oncology Buffalo Radiation Oncology 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Khalil, Moneer Radiation Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301100

Khalil, Moneer Radiation Oncology RPCI Oncology PC 199 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7163326834

Khalil, Moneer Radiation Oncology RADSERVE LLC 495 International Dr Williamsville NY 14221 Erie 7165653999

Khalil, Moneer Radiation Oncology Buffalo Radiation Oncology 626 Frankhauser Rd Williamsville NY 14221 Erie 7166346503

Khalil, Moneer Radiation Oncology RADSERVE LLC 45 Spindrift Dr Williamsville NY 14221 Erie 7165659999

Khalil, Moneer Radiation Oncology Buffalo Radiation Oncology 495 International Dr Buffalo NY 14221 Erie 7165653999

Kossow, Ronald J. Radiation Oncology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Kossow, Ronald J. Radiation Oncology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Kossow, Ronald J. Radiation Oncology CCS Oncology PC 45 Spindrift Dr Williamsville NY 14226 Erie 7168109631

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kuettel, Michael R. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Lee, Jeon H. Radiation Oncology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Malik, Nadia K. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Mattson, David M. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Norlund, John D. Radiation Oncology Southtowns Radiation Oncology 500 Orchard Park Rd Ste A 100 West Seneca NY 14224 Erie 7166746800

Norlund, John D. Radiation Oncology Southtowns Radiation Oncology 495 International Dr Williamsville NY 14221 Erie 7165653999

Panahon, Alvin M. Radiation Oncology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Panahon, Alvin M. Radiation Oncology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Panahon, Alvin M. Radiation Oncology CCS Oncology PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168109631

Panahon, Alvin M. Radiation Oncology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Powell, John W. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Prasad, Dheerendra Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Salerno, Kilian E. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Salerno, Kilian E. Radiation Oncology FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Salerno, Kilian E. Radiation Oncology FDR Medical Services PC 462 Grider St Buffalo NY 14215 Erie 7168984430

Shah, Dhiren K. Radiation Oncology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445500

Shanbhag, Vilasini M. Radiation Oncology Cancer Treatment Service of WNY PC 626 Frankhauser Rd Williamsville NY 14221 Erie 7166346503

Shanbhag, Vilasini M. Radiation Oncology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Shanbhag, Vilasini M. Radiation Oncology Radiation Oncology Group Of WNY PC 626 Frankhauser Rd Williamsville NY 14221 Erie 7166346503

Shanbhag, Vilasini M. Radiation Oncology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Shanbhag, Vilasini M. Radiation Oncology CCS Oncology PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168109631

Shanbhag, Vilasini M. Radiation Oncology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Singh, Anurag K. Radiation Oncology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Tsang, Chi K. Radiation Oncology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301175

Yang, Gary Y. Radiation Oncology Buffalo Medical Group Dept 316 PO Box 8000 Buffalo NY 14267 Erie 7166302513

Yap, Johnny C. Radiation Oncology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Yap, Johnny C. Radiation Oncology CCS Oncology PC 45 Spindrift Williamsville NY 14221 Erie 7168109631

Yap, Johnny C. Radiation Oncology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Yi, Won S. Radiation Oncology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Yi, Won S. Radiation Oncology CCS Oncology PC 45 Spindrift Dr Williamsville NY 14221 Erie 7168109631

Yi, Won S. Radiation Oncology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Yi, Won S. Radiation Oncology Cancer Care Radiology Systems PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Abdelhalim, Ahmed N. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Abdelhalim, Ahmed N. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Agrons, Geoffrey A. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Aiad, Shahir E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Aiad, Shahir E. Radiology - Diagnostic Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

Aiad, Shahir E. Radiology - Diagnostic Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

Aiad, Shahir E. Radiology - Diagnostic Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Aiad, Shahir E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Aiad, Shahir E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Aiad, Shahir E. Radiology - Diagnostic Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14211 Erie 8008410417

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

Aiad, Shahir E. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Aiad, Shahir E. Radiology - Diagnostic Western New York Radiology Assoc 100 High St Buffalo NY 14203 Erie 7168595600

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Aiad, Shahir E. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 7168552866

Aiad, Shahir E. Radiology - Diagnostic Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

Aiad, Shahir E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Aiad, Shahir E. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Akhtar, Amina Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Buffalo NY 14226 Erie 7166327465

Akhtar, Amina Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Akhtar, Amina Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 7168552866

Akhtar, Amina Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Page 128 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Akhtar, Amina Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 7166367800

Akhtar, Amina Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Akhtar, Amina Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Akhtar, Amina Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Akhtar, Amina Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Buffalo NY 14226 Erie 7168344060

Alam, Uzma Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Alberico, Ronald A. Radiology - Diagnostic Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Armfield, Derek R. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Backstrom, James W. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Barna, Jennifer B. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Bath, Shelley S. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Bath, Shelley S. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Bath, Shelley S. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Bath, Shelley S. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Bath, Shelley S. Radiology - Diagnostic Parkland Diagnostic Imaging 3055 Southwestern Blvd Orchard Park NY 14127 Erie 7166776736

Baum, Phillip A. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Buffalo NY 14221 Erie 7165803648

Baum, Phillip A. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Baum, Phillip A. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Baum, Phillip A. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Buffalo NY 14221 Erie 7165650340

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Buffalo NY 14221 Erie 7166894406

Baum, Phillip A. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Baum, Phillip A. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Buffalo NY 14221 Erie 7165686400

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Baum, Phillip A. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Lowr Level Buffalo NY 14203 Erie 7168592840

Baum, Phillip A. Radiology - Diagnostic Northtowns Imaging PC 61 Maple Rd Amherst NY 14051 Erie 7166894406

Baum, Phillip A. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 120 Buffalo NY 14221 Erie 7162048525

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Benedicto, Alberto C. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Benedicto, Alberto C. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Benedicto, Alberto C. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Benedicto, Alberto C. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Bernard, Keith G. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Bisker, Jeffrey S. Radiology - Diagnostic Bisker, Jeffrey 1540 Maple Rd Williamsville NY 14221 Erie 7165686440

Blodgett, Todd M. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Bonaccio, Ermelinda Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Brown, Mark G. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Bula, Melania L. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7168787502

Bula, Melania L. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Caramico, Anthony G. Radiology - Diagnostic Medical Diagnostic Imaging Pllc Dept 878 PO Box 8000 Buffalo NY 12467 Erie 8454715519

Chen, Anna M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Chen, Anna M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Chen, Anna M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Chen, Anna M. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Chen, Anna M. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Chen, Anna M. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Chen, Anna M. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Chen, Anna M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Chen, Anna M. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Cheruvu, Raja S. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Cheruvu, Raja S. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Cheruvu, Raja S. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Cheruvu, Raja S. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Cheruvu, Raja S. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Cheruvu, Raja S. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Cheruvu, Raja S. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Cheruvu, Raja S. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Cheruvu, Raja S. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Page 129 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Chess, Mitchell A. Radiology - Diagnostic LGR Imaging PC 950A Union Plz Office Complex Ste 424 West Seneca NY 14224 Erie 7166714161

Chess, Mitchell A. Radiology - Diagnostic LGR Imaging PC 850 Hopkins Rd Williamsville NY 14221 Erie 7166888977

Chess, Mitchell A. Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Chess, Mitchell A. Radiology - Diagnostic LGR Imaging PC 12845 Broadway St Alden NY 14004 Erie 7166774161

Chess, Mitchell A. Radiology - Diagnostic Advanced Imaging Associates PC 6420 Transit Rd Depew NY 14043 Erie 7166817377

Chess, Mitchell A. Radiology - Diagnostic Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Chess, Mitchell A. Radiology - Diagnostic LGR Imaging PC 4154 Seneca St West Seneca NY 14224 Erie 7166714161

Chess, Mitchell A. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Chess, Mitchell A. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Cholewinski, Scott P. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Cholewinski, Scott P. Radiology - Diagnostic Sisters Diagnostic Imaging 2605 Harlem Rd Buffalo NY 14225 Erie 7166338675

Cholewinski, Scott P. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Cholewinski, Scott P. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Buffalo NY 14217 Erie 7166638675

Chung, Charles J. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Chung, Charles J. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Chung, Charles J. Radiology - Diagnostic University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Chung, Charles J. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Buffalo NY 14225 Erie 7168445300

Chung, Charles J. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Chung, Charles J. Radiology - Diagnostic Western New York Radiology Assoc 100 High St Buffalo NY 14203 Erie 7166348800

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Buffalo NY 14221 Erie 7166894406

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Buffalo NY 14221 Erie 7165803648

Chung, Charles J. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Chung, Charles J. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Chung, Charles J. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Chung, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Buffalo NY 14221 Erie 7165803648

Cipolla, David P. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Buffalo NY 14221 Erie 7166894406

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Cipolla, David P. Radiology - Diagnostic Western New York Radiology Assoc 100 High St Buffalo NY 14203 Erie 7168595600

Cipolla, David P. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Cipolla, David P. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043201

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Buffalo NY 14221 Erie 7166894406

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Cipolla, David P. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Cipolla, David P. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 5853956095

Cipolla, David P. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Conti, Robert R. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Conti, Robert R. Radiology - Diagnostic Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Conti, Robert R. Radiology - Diagnostic Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Conti, Robert R. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Conti, Robert R. Radiology - Diagnostic Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7168578777

Conti, Robert R. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Conti, Robert R. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Conti, Robert R. Radiology - Diagnostic Advanced Imaging Associates PC 2625 Harlem Rd Ste 110 Cheektowaga NY 14225 Erie 7168972207

Conti, Robert R. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Conti, Robert R. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578628

Conti, Robert R. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd West Seneca NY 14224 Erie 7165585400

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Conti, Robert R. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Page 130 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Conti, Robert R. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Conti, Robert R. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Conti, Robert R. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Conti, Robert R. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Cook, Michele A. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Coscia, John Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 9095 Main St Clarence NY 14031 Erie 7162049289

Coscia, John Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Cowie, Albert R. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 12845 Broadway St Alden NY 14004 Erie 7166361902

Cowie, Albert R. Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Cowie, Albert R. Radiology - Diagnostic Diagnostic Imaging Associates LLP 12845 Broadway St Alden NY 14004 Erie 7166361902

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Cowie, Albert R. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Cowie, Albert R. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 9095 Main St Clarence NY 14031 Erie 7162049289

Cowie, Albert R. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Cromwell, Brian G. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Cromwell, Brian G. Radiology - Diagnostic Cardiac Imaging PC 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

Cromwell, Brian G. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Cromwell, Brian G. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Cromwell, Brian G. Radiology - Diagnostic Clarence Cardiology LLC 9095 Main St Clarence NY 14031 Erie 7168874093

Cromwell, Brian G. Radiology - Diagnostic Maple Medical Sevices PC 41 Maple Rd Williamsville NY 14221 Erie 7166311045

Cromwell, Brian G. Radiology - Diagnostic Buffalo Ultrasound, IDTF 388 Evans St Williamsville NY 14221 Erie 7166312262

Cromwell, Brian G. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Cromwell, Brian G. Radiology - Diagnostic Diagnostic X-Ray Service Inc 6000 N Bailey Ave Ste 1C Amherst NY 14226 Erie 7166346633

Cromwell, Brian G. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Cromwell, Brian G. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Cromwell, Brian G. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Cromwell, Brian G. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Cromwell, Brian G. Radiology - Diagnostic Avino, David 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672062

Cromwell, Brian G. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

D'Angelis, Christopher A. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 3154774528

Datta, Vikas Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14224 Erie 7168942100

Datta, Vikas Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

De Zastro, Timothy G. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14211 Erie 8008410417

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

De Zastro, Timothy G. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

De Zastro, Timothy G. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

De Zastro, Timothy G. Radiology - Diagnostic Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

De Zastro, Timothy G. Radiology - Diagnostic Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

De Zastro, Timothy G. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

De Zastro, Timothy G. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Delbalso, Angelo M. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

DeSouza, Aurea S. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Ste 102 105 Amherst NY 14226 Erie 7168344060

DeSouza, Aurea S. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

DeSouza, Aurea S. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

DeSouza, Aurea S. Radiology - Diagnostic Western New York Radiology Assoc 100 High St Buffalo NY 14203 Erie 7168595600

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Page 131 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

DeSouza, Aurea S. Radiology - Diagnostic Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

DeSouza, Aurea S. Radiology - Diagnostic Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 7168552866

DeSouza, Aurea S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

DeSouza, Aurea S. Radiology - Diagnostic Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

DeSouza, Aurea S. Radiology - Diagnostic Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14211 Erie 8008410417

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

DeSouza, Aurea S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

DeSouza, Aurea S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

DeSouza, Aurea S. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Dhillon, Gurmeet S. Radiology - Diagnostic Proscan Imaging Buffalo 5214 Main St Amherst NY 14221 Erie 7168392600

Dhillon, Gurmeet S. Radiology - Diagnostic Buffalo Radiology, PLLC 5214 Main St Williamsville NY 14221 Erie 7168392600

Dhillon, Gurmeet S. Radiology - Diagnostic Proscan Imaging Buffalo 2075 Sheridan Dr Buffalo NY 14223 Erie 7164476474

Ding, Michelle Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Dulai, Harjot S. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Dunleavy, Jason D. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Dunleavy, Jason D. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Dunleavy, Jason D. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Dunleavy, Jason D. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Dunleavy, Jason D. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Dunleavy, Jason D. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Dunleavy, Jason D. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd West Amherst NY 14228 Erie 7166911200

Dunleavy, Jason D. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Dunleavy, Jason D. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Dunn, Andrew T. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Dunn, Andrew T. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Dunn, Andrew T. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Dunn, Andrew T. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Buffalo NY 14226 Erie 7162043201

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Dunn, Andrew T. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Williamsville NY 14221 Erie 7166894406

Dunn, Andrew T. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Dunn, Andrew T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Ehrlich, Anne D. Radiology - Diagnostic Diagnostic Imaging Associates LLP 9095 Main St Clarence NY 14031 Erie 7162049289

Ehrlich, Anne D. Radiology - Diagnostic Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Ehrlich, Anne D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Ehrlich, Anne D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 5959 Big Tree Rd Ste 105 Williamsville NY 14221 Erie 7162561114

Ehrlich, Anne D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Ehrlich, Anne D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7163621545

Ehrlich, Anne D. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Orchard Park NY 14127 Erie 7168787000

Ehrlich, Anne D. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Ehrlich, Anne D. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Ehrlich, Anne D. Radiology - Diagnostic Imaging Services of Western New York PC 222 224 E Main St Springville NY 14141 Erie 7165922871

Ehrlich, Anne D. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166313041

Ehrlich, Anne D. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301000

Ehrlich, Anne D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Ehrlich, Anne D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3620 Sheridan Dr Ste 300 Amherst NY 14226 Erie 7162536002

Ehrlich, Anne D. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Page 132 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Ehrlich, Anne D. Radiology - Diagnostic Diagnostic Imaging Associates LLP 222 224 E Main St Springville NY 14141 Erie 7165922871

Ehrlich, Anne D. Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Ellis, John M. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301020

Ellis, John M. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Ellis, John M. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301000

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Engin, David O. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Engin, David O. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Engin, David O. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Engin, David O. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Engin, David O. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Esfahani, Fraydoon Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Fan, Xinhao C. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Fan, Xinhao C. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Fan, Xinhao C. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Fan, Xinhao C. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Fan, Xinhao C. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Fan, Xinhao C. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Fan, Xinhao C. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Fan, Xinhao C. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Fan, Xinhao C. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Feld, Gregg I. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Femia, Ronald E. Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Femia, Ronald E. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Femia, Ronald E. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787538

Femia, Ronald E. Radiology - Diagnostic People's Choice MRI, LLC 219 Bryant St Buffalo NY 14222 Erie 7168787502

Femia, Ronald E. Radiology - Diagnostic Silver Lake Medical Imaging Llc 219 Byrant St Buffalo NY 14222 Erie 7168787502

Femia, Ronald E. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Femia, Ronald E. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Femia, Ronald E. Radiology - Diagnostic People's Choice MRI, LLC 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166923302

Femia, Ronald E. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166923302

Femia, Ronald E. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Femia, Ronald E. Radiology - Diagnostic Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Femia, Ronald E. Radiology - Diagnostic Silver Lake Medical Imaging Llc 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7166923302

Fenzl, Mark W. Radiology - Diagnostic Juniper Radiology PC 388 Evans St 2nd Fl Williamsville NY 14221 Erie 7166312262

Fenzl, Mark W. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Fenzl, Mark W. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fenzl, Mark W. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Fenzl, Mark W. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Fenzl, Mark W. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Fenzl, Mark W. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Fetouh, Saleh Radiology - Diagnostic Fetouh, Saleh 2828 Main St Buffalo NY 14214 Erie 7168381300

Fitzgerald, James B. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fitzgerald, James B. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Fitzgerald, James B. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Fitzgerald, James B. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Fitzgerald, James B. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Fitzgerald, James B. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Fitzgerald, James B. Radiology - Diagnostic Medicor Associates Inc 565 Abbott Rd Mercy Hospital Buffalo NY 14220 Erie 7168282169

Fitzgerald, James B. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Fitzgerald, James B. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Fitzgerald, James B. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Fitzgerald, John M. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Fitzgerald, John M. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Pk Rd West Seneca NY 14224 Erie 7166499000

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Page 133 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Fitzgerald, John M. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Pk Rd Buffalo NY 14224 Erie 7165585400

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fitzgerald, John M. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Florio, Gerard P. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Florio, William T. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Fosket, Claudia D. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Fosket, Claudia D. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Fosket, Claudia D. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Fosket, Claudia D. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Fosket, Claudia D. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Fosket, Claudia D. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Fosket, Claudia D. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Fosket, Claudia D. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Fosket, Claudia D. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Foti, Anthony M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Foti, Anthony M. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Foti, Anthony M. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Foti, Anthony M. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Foti, Anthony M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Foti, Anthony M. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Foti, Anthony M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Foti, Anthony M. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Foti, Anthony M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Fritz, Russell C. Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Fritz, Russell C. Radiology - Diagnostic Dent Neurologic Group LLP 3980 Sheridan Dr Ste 100 Amherst NY 14226 Erie 7162502000

Fritz, Russell C. Radiology - Diagnostic Dent Neurologic Group LLP 200 Sterling Dr Orchard Park NY 14127 Erie 7162502000

Fuchs, Linda S. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Golden, Grant S. Radiology - Diagnostic Sisters Diagnostic Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476111

Golden, Grant S. Radiology - Diagnostic Sisters Diagnostic Imaging 2605 Harlem Rd Buffalo NY 14225 Erie 7166338675

Golden, Grant S. Radiology - Diagnostic Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621674

Golden, Grant S. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Golden, Grant S. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476020

Golden, Grant S. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Buffalo NY 14217 Erie 7166338675

Golden, Grant S. Radiology - Diagnostic Sisters Diagnostic Imaging 180 Park Club Ln Ste 150 Williamsville NY 14221 Erie 7166338675

Golden, Grant S. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Buffalo NY 14226 Erie 7166338675

Greene, Mary K. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Grossman, Zachary D. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168458015

Gupta, Atul K. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Gurtoo, Lalit K. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Gyves Ray, Katherine M. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7168787502

Gyves Ray, Katherine M. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Halsted, Mark J. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7168787502

Halsted, Mark J. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Hampton, William R. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Hampton, William R. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Hampton, William R. Radiology - Diagnostic Hampton, William 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Hampton, William R. Radiology - Diagnostic Hampton, William 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Hampton, William R. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Hampton, William R. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Hampton, William R. Radiology - Diagnostic Hampton, William 3 Gates Cir Buffalo NY 14209 Erie 7168874600

Hampton, William R. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Hampton, William R. Radiology - Diagnostic Hampton, William 100 High St Buffalo NY 14203 Erie 7168595600

Hampton, William R. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Hampton, William R. Radiology - Diagnostic Hampton, William 200 International Dr Williamsville NY 14221 Erie 7166348800

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Hampton, William R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Hanahan, Laura J. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Hayes, David F. Radiology - Diagnostic Sisters Diagnostic Imaging 2605 Harlem Rd Buffalo NY 14225 Erie 7166338675

Hayes, David F. Radiology - Diagnostic Nuclear Medicine Associates Llp 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476176

Hayes, David F. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476856

Page 134 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Hayes, David F. Radiology - Diagnostic Sisters Diagnostic Imaging 2157 Main St Buffalo NY 14214 Erie 7168622636

Hayes, David F. Radiology - Diagnostic Sisters Diagnostic Imaging 180 Park Club Ln Ste 150 Buffalo NY 14221 Erie 7166338675

Hayes, David F. Radiology - Diagnostic Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621527

Hayes, David F. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Haymes, Allyson A. Radiology - Diagnostic Advanced Imaging Associates PC 2625 Harlem Rd Ste 110 Cheektowaga NY 14225 Erie 7168972207

Haymes, Allyson A. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Hendler, Craig M. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Hendler, Howard M. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Herman, Steven Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Holland, Betsy A. Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Holland, Betsy A. Radiology - Diagnostic Dent Neurologic Group LLP 3980 Sheridan Dr Ste 100 Amherst NY 14226 Erie 7162502000

Holzhauer, Markus K. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Holzhauer, Markus K. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Holzhauer, Markus K. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Holzhauer, Markus K. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Holzhauer, Markus K. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Holzhauer, Markus K. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Holzhauer, Markus K. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Holzhauer, Markus K. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Holzhauer, Markus K. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Holzhauer, Markus K. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Horsley, Ross A. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Horsley, Ross A. Radiology - Diagnostic Radiology Solutions Associates PLLC 3505 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Horsley, Ross A. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Horsley, Ross A. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Iqbal, Vaseem Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Iqbal, Vaseem Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Iqbal, Vaseem Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Iqbal, Vaseem Radiology - Diagnostic Kaleida Health 200 Sterling Dr Orchard Park NY 14127 Erie 7168787000

Iqbal, Vaseem Radiology - Diagnostic Dent Neurologic Group LLP 3980A Sheridan Dr Buffalo NY 14226 Erie 7162502000

Iqbal, Vaseem Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Iqbal, Vaseem Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Iqbal, Vaseem Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Iqbal, Vaseem Radiology - Diagnostic Silver Lake Medical Imaging Llc 100 High St Buffalo NY 14203 Erie 7168592954

Iqbal, Vaseem Radiology - Diagnostic People's Choice MRI, LLC 6420 Transit Rd Depew NY 14043 Erie 7166817377

Iqbal, Vaseem Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Iqbal, Vaseem Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Iqbal, Vaseem Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Iqbal, Vaseem Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Jablonski, Mark G. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Jackson Gibson, Carol A. Radiology - Diagnostic Buffalo General X Ray Associates 1150 Youngs Rd Ste 111 Williamsville NY 14221 Erie 7166887622

Jackson Gibson, Carol A. Radiology - Diagnostic Spectrum Rad Assoc 1150 Youngs Rd Ste 111 Buffalo NY 14221 Erie 7166887622

Jackson Gibson, Carol A. Radiology - Diagnostic Spectrum Rad Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Jandzinski, Dana I. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Pk Rd Buffalo NY 14224 Erie 7165585400

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Jandzinski, Dana I. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Jandzinski, Dana I. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Jandzinski, Dana I. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Pk Rd West Seneca NY 14224 Erie 7166499000

Joyce, Gerald J. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Joyce, Gerald J. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Joyce, Gerald J. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Joyce, Gerald J. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Joyce, Gerald J. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Joyce, Gerald J. Radiology - Diagnostic Medicor Associates Inc 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Joyce, Gerald J. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Pk Rd Buffalo NY 14224 Erie 7165585400

Joyce, Gerald J. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Joyce, Gerald J. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Joyce, Gerald J. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Kale, Jayant G. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Kale, Jayant G. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Kale, Jayant G. Radiology - Diagnostic Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7168578777

Page 135 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kale, Jayant G. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476856

Kale, Jayant G. Radiology - Diagnostic Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621674

Kale, Jayant G. Radiology - Diagnostic Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Kale, Jayant G. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Kale, Jayant G. Radiology - Diagnostic Audubon Womens Medical Assoc Pc 1360 N Forest Rd Williamsville NY 14221 Erie 7166394034

Kale, Jayant G. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Kale, Jayant G. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Buffalo NY 14226 Erie 7168393333

Kale, Jayant G. Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476020

Kaplan, Keith C. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd West Seneca NY 14224 Erie 7165585400

Kaplan, Keith C. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd West Seneca NY 14224 Erie 7165585140

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Kaplan, Keith C. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Buffalo NY 14217 Erie 7166338675

Kaplan, Keith C. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Kaplan, Keith C. Radiology - Diagnostic Sisters Diagnostic Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Kaplan, Keith C. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kaplan, Keith C. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Kartha, Krishnan Radiology - Diagnostic Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14211 Erie 8008410417

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic LGR Imaging PC 4154 Seneca St West Seneca NY 14224 Erie 7166714161

Kartha, Krishnan Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Kartha, Krishnan Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Kartha, Krishnan Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Kartha, Krishnan Radiology - Diagnostic Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 7168552866

Kartha, Krishnan Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Kartha, Krishnan Radiology - Diagnostic Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Kartha, Krishnan Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Kartha, Krishnan Radiology - Diagnostic Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

Kartha, Krishnan Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Kartha, Krishnan Radiology - Diagnostic Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

Kartha, Krishnan Radiology - Diagnostic Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

Kartha, Krishnan Radiology - Diagnostic Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Kartha, Krishnan Radiology - Diagnostic Advanced Imaging Associates PC 2625 Harlem Rd Ste 110 Cheektowaga NY 14225 Erie 7168972207

Katyal, Sanjeev Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Katz, Michael E. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Kessler, Richard A. Radiology - Diagnostic Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621527

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Kessler, Richard A. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Buffalo NY 14217 Erie 7166338675

Kessler, Richard A. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Kessler, Richard A. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Klieger, Peter S. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Koshy, June Radiology - Diagnostic Imaging Services of Western New York PC 222-224 E Main St Springville NY 14141 Erie 7165922871

Koshy, June Radiology - Diagnostic Great Lakes Medical Imaging, LLC 5959 Big Tree Rd Ste 105 Orchard Park NY 14127 Erie 7162561114

Koshy, June Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Page 136 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Koshy, June Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Koshy, June Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Koshy, June Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Koshy, June Radiology - Diagnostic Great Lakes Medical Imaging, LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7163621545

Koshy, June Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Koshy, June Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3620 Sheridan Dr Ste 300 Amherst NY 14226 Erie 7162536002

Kumar, Prasanna R. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Lahr, Patrick F. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Lahr, Patrick F. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Lahr, Patrick F. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Lahr, Patrick F. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd Buffalo NY 14228 Erie 7166911200

Lahr, Patrick F. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Lahr, Patrick F. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Lahr, Patrick F. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Lahr, Patrick F. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Lahr, Patrick F. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Laudico, Thomas J. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Lesh Jr, Charles J. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168592954

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Lesh Jr, Charles J. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Lower Level Buffalo NY 14203 Erie 7168592840

Lesh Jr, Charles J. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168595600

Lesh Jr, Charles J. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Lesh Jr, Charles J. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Buffalo NY 14221 Erie 7165650340

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Lesh Jr, Charles J. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Lesh Jr, Charles J. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 120 Williamsville NY 14221 Erie 7162048525

Lesh Jr, Charles J. Radiology - Diagnostic Northtowns Imaging PC 2733 Wehrle Dr Ste 500 Buffalo NY 14221 Erie 7165803648

Lesh Jr, Charles J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Levin, Terry L. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Levin, Terry L. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Ste 200 Orchard Park NY 14127 Erie 7168787502

Li, Yi Hung Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Li, Yi Hung Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Li, Yi Hung Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Li, Yi Hung Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd Buffalo NY 14228 Erie 7166911200

Li, Yi Hung Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Li, Yi Hung Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Li, Yi Hung Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Li, Yi Hung Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Li, Yi Hung Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Licata, Michael Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Licata, Michael Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Licata, Michael Radiology - Diagnostic Southtowns Radiological As 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Licata, Michael Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7166499000

Licata, Michael Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Licata, Michael Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Licata, Michael Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Licata, Michael Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Licata, Michael Radiology - Diagnostic Medicor Associates Inc 3669 Southwestern Blvd Orchard Park NY 14127 Erie 7166620500

Licata, Michael Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Licata, Michael Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Lieberman, Jeffrey L. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Lieberman, Jeffrey L. Radiology - Diagnostic LGR Imaging PC 4154 Seneca St West Seneca NY 14224 Erie 7166770500

Lieberman, Jeffrey L. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Lieberman, Jeffrey L. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Page 137 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lieberman, Jeffrey L. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Lieberman, Jeffrey L. Radiology - Diagnostic Parkland Diagnostic Imaging 3055 Southwestern Blvd Ste 104 Orchard Park NY 14127 Erie 7166776736

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Lieberman, Jeffrey L. Radiology - Diagnostic Jeffrey L Lieberman 51 S Meadow Dr Orchard Park NY 14127 Erie 7166620293

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 1275 Delaware Ave Buffalo NY 14209 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Lieberman, Jeffrey L. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Lieberman, Jeffrey L. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 7168552866

Loftus, Randall J. Radiology - Diagnostic Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

Loftus, Randall J. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

Loftus, Randall J. Radiology - Diagnostic WNY PETCT LLC 425 Michigan Ave Buffalo NY 14203 Erie 7168482160

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Loftus, Randall J. Radiology - Diagnostic Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Loftus, Randall J. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Loftus, Randall J. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Loftus, Randall J. Radiology - Diagnostic Eastern Niagara Radiology Associates 425 Michigan Ave Buffalo NY 14203 Erie 7168552860

Loftus, Randall J. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Loud, Peter A. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Ludwig, David R. Radiology - Diagnostic Parkland Diagnostic Imaging 3055 Southwestern Blvd Ste 104 Orchard Park NY 14127 Erie 7166776736

Ludwig, David R. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 ORCHARD PARK RD West Seneca NY 14224 Erie 7166753700

Ludwig, David R. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 DELAWARE AVE Buffalo NY 14216 Erie 7168742273

Ludwig, David R. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 NIAGRA FALLS BLVD Amherst NY 14228 Erie 7165642273

Ludwig, David R. Radiology - Diagnostic Dent Neurologic Group LLP 7020 Erie Rd Rte 5 Derby NY 14047 Erie 7162502000

Ludwig, David R. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 TRANSIT RD Williamsville NY 14221 Erie 7162042273

Ludwig, David R. Radiology - Diagnostic Dent Neurologic Group LLP 3980A Sheridan Dr Amherst NY 14226 Erie 7162502000

Lutnick, Robert E. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Lutnick, Robert E. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 8772357686

Lutnick, Robert E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Lutnick, Robert E. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Majewski, Sara A. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Streets Buffalo NY 14263 Erie 7168452300

Makhija, Jasbeer S. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Makhija, Jasbeer S. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166891791

Makhija, Jasbeer S. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Page 138 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Makhija, Jasbeer S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Makhija, Jasbeer S. Radiology - Diagnostic Northtowns Imaging PC 61 Maple Rd Amherst NY 14051 Erie 7166894406

Makhija, Jasbeer S. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168595600

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Mangano, Anthony R. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Mangano, Anthony R. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Mangano, Anthony R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Mangano, Anthony R. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Mangano, Anthony R. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Mark, Ron Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Marshall, Jonathan T. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Marshall, Jonathan T. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Mascaro, Frank J. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 222 Genese St Buffalo NY 14203 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Mascaro, Frank J. Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 7168983000

Mascaro, Frank J. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Mason, Thomas O. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Mason, Thomas O. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Mason, Thomas O. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Mason, Thomas O. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Masrani, Deepa Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Mastroianni, Travis A. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Mastroianni, Travis A. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Mastroianni, Travis A. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Mastroianni, Travis A. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

McDonnell, Andrew J. Radiology - Diagnostic Finger Lakes Radiology LLC PO Box 8000 Dept 044 Buffalo NY 14267 Erie 7166923302

Page 139 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Mikityansky, Igor Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Mikityansky, Igor Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd Buffalo NY 14228 Erie 7166911200

Mikityansky, Igor Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Mikityansky, Igor Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 Buffalo NY 14224 Erie 7166755600

Mikityansky, Igor Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Mikityansky, Igor Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Mikityansky, Igor Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Mikityansky, Igor Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Mikityansky, Igor Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Miller, Michael T. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Miller, Michael T. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Miller, Michael T. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Miller, Michael T. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Miller, Michael T. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Miller, Michael T. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Milligan, Janine M. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Mogil, Irene Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Mogil, Irene Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Mogil, Irene Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 Buffalo NY 14224 Erie 7166755600

Mogil, Irene Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Mogil, Irene Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Mogil, Irene Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd Buffalo NY 14228 Erie 7166911200

Mogil, Irene Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Mogil, Irene Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Mogil, Irene Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Montgomery, Paul Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Montgomery, Paul Radiology - Diagnostic Imaging Services of Western New York PC 222 224 E Main St Springville NY 14141 Erie 7165922871

Montgomery, Paul Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Montgomery, Paul Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3620 Sheridan Dr Ste 300 Amherst NY 14226 Erie 7162536002

Montgomery, Paul Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Montgomery, Paul Radiology - Diagnostic Great Lakes Medical Imaging, LLC 5959 Big Tree Rd Ste 105 Orchard Park NY 14127 Erie 7162561114

Montgomery, Paul Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Montgomery, Paul Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Buffalo NY 14221 Erie 7166891901

Montgomery, Paul Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166313041

Montgomery, Paul Radiology - Diagnostic Great Lakes Medical Imaging, LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7163621545

Montgomery, Paul Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Montgomery, Paul Radiology - Diagnostic Diagnostic Imaging Associates LLP 222 224 E Main St Springville NY 14141 Erie 7165922871

Montgomery, Paul Radiology - Diagnostic Diagnostic Imaging Associates LLP 9095 Main St Clarence NY 14031 Erie 7162049289

Montgomery, Paul Radiology - Diagnostic Kaleida Health 200 Sterling Dr Orchard Park NY 14127 Erie 7168787000

Montgomery, Paul Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Morrell, Joseph Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Morrell, Joseph Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Moudy, Philip Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168626015

Najdzionek, Jan S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Najdzionek, Jan S. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Najdzionek, Jan S. Radiology - Diagnostic Diagnostic Imaging Associates LLP 222 224 E Main St Springville NY 14141 Erie 7165922871

Najdzionek, Jan S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7163621545

Page 140 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Najdzionek, Jan S. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Najdzionek, Jan S. Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Najdzionek, Jan S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3620 Sheridan Dr Ste 300 Amherst NY 14226 Erie 7162536002

Najdzionek, Jan S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Najdzionek, Jan S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 5959 Big Tree Rd Ste 105 Orchard Park NY 14127 Erie 7162561114

Najdzionek, Jan S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Najdzionek, Jan S. Radiology - Diagnostic Diagnostic Imaging Associates LLP 9095 Main St Clarence NY 14031 Erie 7162049289

Najdzionek, Jan S. Radiology - Diagnostic Imaging Services of Western New York PC 222 224 E Main St Springville NY 14141 Erie 7165922871

Najdzionek, Jan S. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Orchard Park NY 14127 Erie 7168787000

Nam, Kwang Joon Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Naples, Nicholas Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Naples, Nicholas Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Naples, Nicholas Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Naples, Nicholas Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Naples, Nicholas Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

Naples, Nicholas Radiology - Diagnostic Imaging Associates of Buffalo PC 6420 Transit Road Depew NY 14043 Erie 7163933789

Nigam, Ashok Radiology - Diagnostic Spectrum Rad Assoc 1150 Youngs Rd Ste 111 Buffalo NY 14221 Erie 7166887622

Notino, Anthony G. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Notino, Anthony G. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Notino, Anthony G. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Notino, Anthony G. Radiology - Diagnostic University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Notino, Anthony G. Radiology - Diagnostic Apex Imaging I , PC 4949 Harlem Rd 1st Fl Amherst NY 14226 Erie 7162043200

Notino, Anthony G. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Notino, Anthony G. Radiology - Diagnostic Northtowns Imaging PC 1000 Youngs Rd Williamsville NY 14221 Erie 7166894406

Notino, Anthony G. Radiology - Diagnostic Northtowns Imaging PC 8750 Transit Rd East Amherst NY 14051 Erie 7165642400

Notino, Anthony G. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Notino, Anthony G. Radiology - Diagnostic Western New York Radiology Assoc 100 High St Buffalo NY 14203 Erie 7168592954

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Notino, Anthony G. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Oliverio, Roseanne Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Oliverio, Roseanne Radiology - Diagnostic Great Lakes Medical Imaging, LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7163621545

Oliverio, Roseanne Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Oliverio, Roseanne Radiology - Diagnostic Sisters Diagnostic Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476111

Oliverio, Roseanne Radiology - Diagnostic Western New York Radiology Assoc 100 High St Buffalo NY 14203 Erie 7168595600

Oliverio, Roseanne Radiology - Diagnostic Northtowns Imaging PC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Oliverio, Roseanne Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Oliverio, Roseanne Radiology - Diagnostic Northtowns Imaging PC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Oliverio, Roseanne Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Buffalo NY 14221 Erie 7168364646

Oliverio, Roseanne Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Oliverio, Roseanne Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Oliverio, Roseanne Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Oliverio, Roseanne Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Oliverio, Roseanne Radiology - Diagnostic Apex Imaging I , PC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Oliverio, Roseanne Radiology - Diagnostic Apex Imaging I , PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Oliverio, Roseanne Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Oliverio, Roseanne Radiology - Diagnostic Apex Imaging I , PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Oliverio, Roseanne Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Oliverio, Roseanne Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476856

Ondracek, Theodore C. Radiology - Diagnostic University at Buffalo Pathologists PC 100 High St Buffalo NY 14203 Erie 7168595600

Page 141 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Patel, Nikhil C. Radiology - Diagnostic Sadashiv S Shenoy MD PLLC 2949 Elmwood Ave Ste 201 Buffalo NY 14267 Erie 7168770053

Patel, Nikhil C. Radiology - Diagnostic Shenoy, Sadashiv 2949 Elmwood Ste 201 Buffalo NY 14213 Erie 7168770053

Patel, Susanj S. Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Paul, David A. Radiology - Diagnostic Diagnostic X-Ray Service Inc 6000 N Bailey Ave Ste 1B Amherst NY 14226 Erie 7166346633

Paul, David A. Radiology - Diagnostic Paul, David 462 Grider St Buffalo NY 14215 Erie 7168983417

Paul, David A. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983157

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Pearsen, Kenneth D. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166891791

Pearsen, Kenneth D. Radiology - Diagnostic University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Pearsen, Kenneth D. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Pearsen, Kenneth D. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Pearsen, Kenneth D. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

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Pearsen, Kenneth D. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Pearsen, Kenneth D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Pearsen, Kenneth D. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

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Pericak, Jason R. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Pericak, Jason R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

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Pericak, Jason R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Pericak, Jason R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Pericak, Jason R. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

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Pericak, Jason R. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

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Perry, Mark D. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Perry, Mark D. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

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Petroziello, Michael Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

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Phillies, Gregory P. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

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Phillies, Gregory P. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

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Phillies, Gregory P. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

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Pizzella, Paul F. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

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Pizzella, Paul F. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Page 142 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Pizzella, Paul F. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

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Pizzella, Paul F. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Pizzella, Paul F. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Pizzella, Paul F. Radiology - Diagnostic Sisters Diagnostic Imaging 2157 Main St Buffalo NY 14214 Erie 7168621527

Pizzella, Paul F. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Pizzella, Paul F. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476856

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Pizzella, Paul F. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Powell, Aaron M. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Powell, Aaron M. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Powell, Aaron M. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

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Powell, Aaron M. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7165585400

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Powell, Aaron M. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

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Qureshi, Zeeshan M. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

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Qureshi, Zeeshan M. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

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Qureshi, Zeeshan M. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

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Qureshi, Zeeshan M. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

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Rand, Lawrence G. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Rand, Lawrence G. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Rand, Lawrence G. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Rand, Lawrence G. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rand, Lawrence G. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd Buffalo NY 14224 Erie 7155585400

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Rand, Lawrence G. Radiology - Diagnostic LGR Imaging PC 950A Union Plaza Office Complex Ste 424 West Seneca NY 14224 Erie 7166714161

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Rand, Lawrence G. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

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Ray, Jennifer K. Radiology - Diagnostic Southtowns Radiological As 397 Louisiana St Buffalo NY 14204 Erie 7168476610

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Ray, Jennifer K. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

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Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Regenbogen, Victor S. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Page 143 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Regenbogen, Victor S. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Regenbogen, Victor S. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Regenbogen, Victor S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Regenbogen, Victor S. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Regenbogen, Victor S. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Regenbogen, Victor S. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Regenbogen, Victor S. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

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Rinaldi, James J. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

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Rinaldi, James J. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Rinaldi, James J. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Rinaldi, James J. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Buffalo NY 14221 Erie 7165650340

Rinaldi, James J. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Rinaldi, James J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Rinaldi, James J. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Rinaldi, James J. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Rinaldi, James J. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

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Rinaldi, James J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Rinaldi, James J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Rinaldi, James J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Rinaldi, James J. Radiology - Diagnostic University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

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Rinaldi, James J. Radiology - Diagnostic Apex Imaging I , PC 4949 Harlem Rd 1st Fl Amherst NY 14226 Erie 7162043200

Rinaldi, James J. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Lowr Level Buffalo NY 14203 Erie 7168592840

Roche, Charles L. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Rockwell, Bruce H. Radiology - Diagnostic Circulatory Centers New York LLP 63 Park Club Ln Williamsville NY 14221 Erie 7162040036

Rosenberg, Barry I. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Rosenberg, Barry I. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Rosenberg, Barry I. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Rosenberg, Barry I. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Rowland, David M. Radiology - Diagnostic Nuclear Medicine Associates Llp 2157 Main St Buffalo NY 14214 Erie 7168621674

Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Rowland, David M. Radiology - Diagnostic Sisters Diagnostic Imaging 2157 Main St Buffalo NY 14214 Erie 7168621180

Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Rowland, David M. Radiology - Diagnostic Seton Imaging 3730 Sheridan Dr Amherst NY 14226 Erie 7166338675

Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

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Rowland, David M. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Rowland, David M. Radiology - Diagnostic Seton Imaging 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476856

Rubin, Stuart J. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Rubin, Stuart J. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Rubin, Stuart J. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Page 144 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Rubin, Stuart J. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

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Rusnak, Joseph G. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

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Rusnak, Joseph G. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Rusnak, Joseph G. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

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Saber, Cameron R. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

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Saber, Cameron R. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd West Amherst NY 14228 Erie 7166911200

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Schlehr, James M. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168628624

Scorza, Lari M. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

SDoia, Samuel W. Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

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Serghany, Joseph E. Radiology - Diagnostic Amherst Diagnostic Imaging PC 350 Alberta Dr Stes 102 105 Amherst NY 14226 Erie 7168344060

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 462 Grider St Buffalo NY 14215 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Advanced Imaging Associates PC 2625 Harlem Rd Ste 110 Cheektowaga NY 14225 Erie 7168972207

Serghany, Joseph E. Radiology - Diagnostic Diagnostic Imaging Associates LLP 9095 Main St Clarence NY 14031 Erie 7162049289

Serghany, Joseph E. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 9095 Main St Clarence NY 14031 Erie 7162049289

Serghany, Joseph E. Radiology - Diagnostic Eastern Niagara Radiology Associates 222 Genesee St Buffalo NY 14203 Erie 8008410417

Serghany, Joseph E. Radiology - Diagnostic Eastern Niagara Radiology Associates 899 Main St Buffalo NY 14202 Erie 8008410417

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Serghany, Joseph E. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Serghany, Joseph E. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Eastern Niagara Radiology Associates 564 Niagara St Buffalo NY 14202 Erie 8008410417

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Diagnostic Imaging Associates LLP 12845 Broadway St Alden NY 14004 Erie 7166361902

Serghany, Joseph E. Radiology - Diagnostic Eastern Niagara Radiology Associates 840 Humboldt Pkwy Buffalo NY 14203 Erie 8008410417

Serghany, Joseph E. Radiology - Diagnostic LGR Imaging PC 4154 Seneca St West Seneca NY 14224 Erie 7166770500

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Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

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Serghany, Joseph E. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 12845 Broadway St Alden NY 14004 Erie 7166361902

Page 145 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Serghany, Joseph E. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Serghany, Joseph E. Radiology - Diagnostic Eastern Niagara Radiology Associates 8370 Main St Williamsville NY 14221 Erie 8008410417

Serghany, Joseph E. Radiology - Diagnostic VA Western NY Health Med Ctr 462 Grider St Buffalo NY 14215 Erie 7168983000

Serghany, Joseph E. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Sethi, Ami Radiology - Diagnostic Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

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Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14214 Erie 7168983313

Shah, Keyur S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Shah, Keyur S. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Shah, Keyur S. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Shea, Kevin S. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Shea, Kevin S. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Shea, Kevin S. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Shea, Kevin S. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Shea, Kevin S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Shenoy, Sadashiv S. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Shenoy, Sadashiv S. Radiology - Diagnostic Sadashiv S Shenoy MD PLLC 2949 Elmwood Ave Ste 201 Kenmore NY 14217 Erie 7168770053

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Shields, Gregory S. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Shields, Gregory S. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Shields, Gregory S. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Shields, Gregory S. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Shields, Gregory S. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168592954

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Shields, Gregory S. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Lowr Level Buffalo NY 14203 Erie 7168592840

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Shields, Gregory S. Radiology - Diagnostic University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Shields, Gregory S. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Buffalo NY 14221 Erie 7165650340

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Shields, Gregory S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 156 West Ave Buffalo NY 14267 Erie 5856373131

Shields, Gregory S. Radiology - Diagnostic Apex Imaging I , PC 4949 Harlem Rd 1st Fl Amherst NY 14226 Erie 7162043200

Silber, Michael S. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Silber, Michael S. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Silber, Michael S. Radiology - Diagnostic Northtowns Imaging PC 61 Maple Rd Amherst NY 14051 Erie 7166894406

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Silber, Michael S. Radiology - Diagnostic Western New York Radiology Assoc 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Silber, Michael S. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Silber, Michael S. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Silber, Michael S. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Silber, Michael S. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Silber, Michael S. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Page 146 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Small, Teresa J. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Small, Teresa J. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Small, Teresa J. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Small, Teresa J. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Small, Teresa J. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Small, Teresa J. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Small, Teresa J. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Small, Teresa J. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Small, Teresa J. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Smith Jr, Roger M. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Snitzer, Eric L. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Snitzer, Eric L. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Snitzer, Eric L. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Snitzer, Eric L. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Snitzer, Eric L. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Snitzer, Eric L. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Snitzer, Eric L. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Snitzer, Eric L. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Snitzer, Eric L. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Soehnlein, Stephanie L. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Soehnlein, Stephanie L. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd West Seneca NY 14224 Erie 7165585140

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Soehnlein, Stephanie L. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Park Rd West Seneca NY 14224 Erie 7165885400

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 2157 Main St Buffalo NY 14214 Erie 7168621000

Soehnlein, Stephanie L. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476020

Sponaugle, Dale W. Radiology - Diagnostic Radiology Solutions Associates PLLC 2099 Niagara Falls Blvd Amherst NY 14228 Erie 7165642273

Sponaugle, Dale W. Radiology - Diagnostic Radiology Solutions Associates PLLC 7616 Transit Rd Williamsville NY 14221 Erie 7162042273

Sponaugle, Dale W. Radiology - Diagnostic Radiology Solutions Associates PLLC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166753700

Sponaugle, Dale W. Radiology - Diagnostic Radiology Solutions Associates PLLC 2497 Delaware Ave Buffalo NY 14216 Erie 7168742273

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Stokoe, Gail E. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Stokoe, Gail E. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Stokoe, Gail E. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Stokoe, Gail E. Radiology - Diagnostic Northtowns Imaging PC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Stokoe, Gail E. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Stokoe, Gail E. Radiology - Diagnostic University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Stokoe, Gail E. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Stokoe, Gail E. Radiology - Diagnostic University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Stokoe, Gail E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Stoll III, Howard L. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Stoll III, Howard L. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Stoll III, Howard L. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Stoll III, Howard L. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Stoll III, Howard L. Radiology - Diagnostic Juniper Radiology PC 388 Evans St 2nd Fl Williamsville NY 14221 Erie 7166312262

Stoll III, Howard L. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Stoll III, Howard L. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Summers, Thomas A. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Summers, Thomas A. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Summers, Thomas A. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Summers, Thomas A. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Summers, Thomas A. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Summers, Thomas A. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Summers, Thomas A. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Summers, Thomas A. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Summers, Thomas A. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Sung, Janet H. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Sung, Janet H. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Page 147 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Sung, Janet H. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Sung, Janet H. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Sung, Janet H. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Sung, Janet H. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Sung, Janet H. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Sung, Janet H. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Sung, Janet H. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 564 Niagara St Buffalo NY 14201 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 180 Park Club Ln Williamsville NY 14221 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Tan, Vivian C. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Tan, Vivian C. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Tang, Yi Radiology - Diagnostic VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Thomas, Richard D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Thomas, Richard D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Thomas, Richard D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7163621545

Thomas, Richard D. Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Thomas, Richard D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 5959 Big Tree Rd Ste 105 Orchard Park NY 14127 Erie 7162561114

Thomas, Richard D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3620 Sheridan Dr Ste 300 Amherst NY 14226 Erie 7162536002

Thomas, Richard D. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Thomas, Richard D. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Thomas, Richard D. Radiology - Diagnostic Diagnostic Imaging Associates LLP 9095 Main St Clarence NY 14031 Erie 7162049289

Thomas, Richard D. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578636

Thomas, Richard D. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166313041

Thomas, Richard D. Radiology - Diagnostic Imaging Services of Western New York PC 222 224 E Main St Springville NY 14141 Erie 7165922871

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Thomas, Richard D. Radiology - Diagnostic Diagnostic Imaging Associates LLP 222 224 E Main St Springville NY 14141 Erie 7165922871

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Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 550 Orchard Park Rd West Seneca NY 14224 Erie 8772357686

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Tirone, Charles S. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Tirone, Charles S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 3915 Sheridan Dr Amherst NY 14226 Erie 8667197687

Tirone, Charles S. Radiology - Diagnostic Charles Tirone MD 388 Evans St Williamsville NY 14221 Erie 7166312262

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 656 Elmwood Ave Buffalo NY 14222 Erie 8772357686

Tirone, Charles S. Radiology - Diagnostic Buffalo Ultrasound, IDTF 388 Evans St Williamsville NY 14221 Erie 7166312262

Tirone, Charles S. Radiology - Diagnostic Ken-Ton Open MRI, PC 2882 Elmwood Ave Kenmore NY 14217 Erie 8667197687

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 3980 Sheridan Dr Amherst NY 14226 Erie 8772357686

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 222 Genesee St Buffalo NY 14203 Erie 8772357686

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Tirone, Charles S. Radiology - Diagnostic Sisters Diagnostic Imaging 180 Park Club Ln Ste 150 Buffalo NY 14221 Erie 7166338675

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 4979 Harlem Rd Buffalo NY 14226 Erie 8772357686

Tirone, Charles S. Radiology - Diagnostic Amherst Diagnostic Imaging PC 8270 Wehrle Dr Williamsville NY 14221 Erie 8667197687

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 840 Humboldt Pkwy Buffalo NY 14211 Erie 8772357686

Tirone, Charles S. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 8667197687

Tirone, Charles S. Radiology - Diagnostic Saturn Radiology PLLC 462 Grider St Buffalo NY 14215 Erie 7168983313

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 1416 Sweet Home Rd Ste 12 Amherst NY 14228 Erie 8772357686

Tirone, Charles S. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Tirone, Charles S. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Tirone, Charles S. Radiology - Diagnostic Western New York MRI, LLP 184 Barton St Buffalo NY 14203 Erie 8772357686

Tomaszewski, Garin M. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Tomaszewski, Garin M. Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Turkiewicz, Mary L. Radiology - Diagnostic SRA Medical Imaging LLC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Turkiewicz, Mary L. Radiology - Diagnostic Southtowns Radiological As 3050 Orchard Pk Rd West Seneca NY 14224 Erie 7165585400

Turkiewicz, Mary L. Radiology - Diagnostic SRA Medical Imaging LLC 94 Olean Rd East Aurora NY 14052 Erie 7166552525

Turkiewicz, Mary L. Radiology - Diagnostic Southtowns Radiological As 550 Orchard Park Rd Buffalo NY 14224 Erie 7165585140

Turkiewicz, Mary L. Radiology - Diagnostic SRA Medical Imaging LLC 397 Louisiana St Buffalo NY 14204 Erie 7168476610

Page 148 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Turkiewicz, Mary L. Radiology - Diagnostic SRA Medical Imaging LLC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Turkiewicz, Mary L. Radiology - Diagnostic Southtowns Radiological As 3040 Amsdell Rd Hamburg NY 14075 Erie 7166499000

Turkiewicz, Mary L. Radiology - Diagnostic SRA Medical Imaging LLC 550 Orchard Park Rd West Seneca NY 14224 Erie 7166775000

Turkiewicz, Mary L. Radiology - Diagnostic SRA Medical Imaging LLC 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Tymchak, Gregory T. Radiology - Diagnostic Diagnostic Imaging Associates LLP 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Tymchak, Gregory T. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 100 College Pkwy Ste 180 Williamsville NY 14221 Erie 7166361902

Tymchak, Gregory T. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301000

Tymchak, Gregory T. Radiology - Diagnostic WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Tymchak, Gregory T. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166313041

Tymchak, Gregory T. Radiology - Diagnostic Kaleida Health 100 College pkwy Ste 180 Buffalo NY 14221 Erie 7166361902

Tymchak, Gregory T. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 9095 Main St Clarence NY 14031 Erie 7162049289

Tymchak, Gregory T. Radiology - Diagnostic Kaleida Health 200 Sterling Dr Orchard Park NY 14127 Erie 7168787000

Tymchak, Gregory T. Radiology - Diagnostic Diagnostic Imaging Associates LLP 222 E Main ST 224 Springville NY 14141 Erie 7165922871

Tymchak, Gregory T. Radiology - Diagnostic Kaleida Health 12845 Broadway St Alden NY 14004 Erie 7163124683

Tymchak, Gregory T. Radiology - Diagnostic Diagnostic Imaging Associates LLP 9095 Main St Clarence NY 14031 Erie 7162049289

Tymchak, Gregory T. Radiology - Diagnostic Diagnostic Imaging Associates LLP 12845 Broadway St Alden NY 14004 Erie 7166361902

Tymchak, Gregory T. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Tymchak, Gregory T. Radiology - Diagnostic Kaleida Health 9095 Main St Ste E Clarence NY 14031 Erie 7162049289

Tymchak, Gregory T. Radiology - Diagnostic Michael K Landi MD dba Brain and Spine Medical Services 12845 Broadway St Alden NY 14004 Erie 7166361902

Vijaykumar, Rekha Radiology - Diagnostic Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Winter, Steven W. Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Wolf, David M. Radiology - Diagnostic Windsong Radiology Pc 55 Spindrift Dr Williamsville NY 14221 Erie 7166312500

Wolf, David M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 151 Elmview Ave Hamburg NY 14075 Erie 7166483040

Wolf, David M. Radiology - Diagnostic Windsong Radiology Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166312500

Wolf, David M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 899 Main St Buffalo NY 14203 Erie 7168782700

Wolf, David M. Radiology - Diagnostic Windsong Radiology Pc 1026 Union Rd Ste 1 West Seneca NY 14224 Erie 7166755600

Wolf, David M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 1185 Sweet Home Rd Buffalo NY 14226 Erie 7166890040

Wolf, David M. Radiology - Diagnostic Genesee Valley Group Health Association Lifetime Health 120 Gardenville Pkwy W Buffalo NY 14224 Erie 7166683600

Wolf, David M. Radiology - Diagnostic Windsong Radiology Pc 3950 E Robinson Rd W Amherst NY 14228 Erie 7166911200

Wolf, David M. Radiology - Diagnostic Windsong Radiology Pc 4893 Transit Rd Depew NY 14043 Erie 7166684600

Yacobucci, Dean V. Radiology - Diagnostic Buffalo Medical Group 425 Essjay Rd Williamsville NY 14221 Erie 7166301112

Yacobucci, Dean V. Radiology - Diagnostic Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301112

Yacobucci, Dean V. Radiology - Diagnostic Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301112

Yacobucci, Dean V. Radiology - Diagnostic Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787502

Yuz, Michael Radiology - Diagnostic Buffalo Diagnostic Imaging PLLC 4925 Main St Amherst NY 14226 Erie 7168393333

Zimmer, Wendy E. Radiology - Diagnostic Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3 Gates Cir Buffalo NY 14209 Erie 7168774800

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 2733 Wehrle Dr Ste 500 Williamsville NY 14221 Erie 7165803648

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 3085 Harlem Rd Ste 150 Cheektowaga NY 14225 Erie 7168445300

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1020 Youngs Rd Ste 120 Williamsville NY 14221 Erie 7166894406

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 100 High St Buffalo NY 14203 Erie 7168595600

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 199 Park Club Ln Ste 300 Williamsville NY 14221 Erie 7168364646

Zimmer, Wendy E. Radiology - Diagnostic Great Lakes Medical Imaging, LLC 1540 Maple Rd Williamsville NY 14221 Erie 7165686400

Zimmer, Wendy E. Radiology - Diagnostic Apex Imaging I , PC 3085 Harlem Rd Cheektowaga NY 14225 Erie 7168445300

Zimmer, Wendy E. Radiology - Diagnostic Northtowns Imaging PC 1829 Maple Rd Ste 102 Amherst NY 14226 Erie 7165650340

Zimmer, Wendy E. Radiology - Diagnostic Northtowns Imaging PC 2828 Sheridan Dr Tonawanda NY 14150 Erie 7168364646

Zimmer, Wendy E. Radiology - Diagnostic Western New York Radiology Assoc 100 High St 2nd Fl Buffalo NY 14203 Erie 7168592954

Crickard, Kent Reproductive Endo/Infert Infertility & IVF Medical Assoc 4510 Main St Buffalo NY 14226 Erie 7168393057

Greene, Robert A. Reproductive Endo/Infert Cny Fertility Center 835 Hopkins Rd Williamsville NY 14221 Erie 3157011660

Griffin, Adam M. Reproductive Endo/Infert Infertility & IVF Medical Assoc 4510 Main St Buffalo NY 14226 Erie 7168393057

Kiltz, Robert J. Reproductive Endo/Infert Cny Fertility Center 835 Hopkins Rd Williamsville NY 14221 Erie 3154698700

Sulewski, Joanne M. Reproductive Endo/Infert University Gynecologists & Obstetriciansstate Universit 219 Bryant St Buffalo NY 14222 Erie 7168787861

Sulewski, Joanne M. Reproductive Endo/Infert VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Sulewski, Joanne M. Reproductive Endo/Infert University Gynecologists & Obstetriciansstate Universit 1540 Maple Rd Ste 25 Williamsville NY 14221 Erie 7165686572

Sullivan, Michael W. Reproductive Endo/Infert Infertility & IVF Medical Assoc 4510 Main St Buffalo NY 14226 Erie 7168393057

Abialmouna, Jihad H. Rheumatology Tonawanda Medical Practice PC 2800 Sweethome Rd Ste 6 West Amherst NY 14228 Erie 7166911300

Abialmouna, Jihad H. Rheumatology Tonawanda Medical Practice PC 2882 Elmwood Ave Kenmore NY 14217 Erie 7166911300

Ahmed, Sadia N. Rheumatology Buffalo Rheumatology 3055 Southwestern Blvd Orchard Park NY 14127 Erie 7166752500

Ahmed, Sadia N. Rheumatology Buffalo Rheumatology 3500 Sheridan Dr Amherst NY 14226 Erie 7166752500

Ahmed, Sadia N. Rheumatology Ahmed & Ahmed Physicians PC 8207 Main St Ste 7 And 8 Williamsville NY 14221 Erie 7166264200

Botsoglou, Kostas N. Rheumatology Kostas N Botsoglou MD 2475 Harlem Rd Cheektowaga NY 14225 Erie 7168965922

Botsoglou, Kostas N. Rheumatology Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Botsoglou, Kostas N. Rheumatology Buffalo Rheumatology 3500 Sheridan Dr Amherst NY 14226 Erie 7162044261

Burns, Linda M. Rheumatology Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Chadha, Sunita Rheumatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Chadha, Sunita Rheumatology Chadha Medicals PC 1825 Maple Rd Buffalo NY 14221 Erie 7168109292

Page 149 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Chadha, Sunita Rheumatology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168984808

Chadha, Sunita Rheumatology Academic Medicine Services 3980 Sheridan Dr Ste 601 Amherst NY 14226 Erie 7168826544

Dang, Neha Rheumatology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Dang, Neha Rheumatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983152

Dhillon, Rajwinder S. Rheumatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983148

Dhillon, Rajwinder S. Rheumatology Academic Medicine Services 3980 Sheridan Dr Ste 601 Amherst NY 14226 Erie 7168826544

Dhillon, Rajwinder S. Rheumatology Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983000

Dhillon, Rajwinder S. Rheumatology Kaleida Health 100 High St Specialty Clinic D Ground Buffalo NY 14203 Erie 7168592282

Gomez, Emoke Rheumatology Tonawanda Medical Practice PC 2800 Sweethome Rd Ste 6 Amherst NY 14228 Erie 7166911300

Grisanti, Joseph M. Rheumatology Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Grisanti, Michael W. Rheumatology Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Grisanti, Michael W. Rheumatology Buffalo Rheumatology 3500 Sheridan Dr Amherst NY 14226 Erie 7166752500

Kaprove, Robert E. Rheumatology Robert E Kaprove dba Rheumatology Consultants of WNY PC 3615 Seneca St Ste F West Seneca NY 14224 Erie 7166757376

Krutchick, Karen L. Rheumatology Robert E Kaprove dba Rheumatology Consultants of WNY PC 3615 Seneca St Ste F West Seneca NY 14224 Erie 7166757376

Levy, Ernesto N. Rheumatology Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

Levy, Ernesto N. Rheumatology Michael K Landi MD dba Brain and Spine Medical Services 7060 Erie Rd Derby NY 14047 Erie 7166313555

Mallela, Rajitha Rheumatology Buffalo Medical Group 295 Essjay Rd Buffalo NY 14221 Erie 7168578666

Martinez, Carlos L. Rheumatology Martinez, Carlos 2291 Union Rd West Seneca NY 14224 Erie 7166686146

Michalski, Stanley R. Rheumatology Michael K Landi MD dba Brain and Spine Medical Services 400 International Dr Williamsville NY 14221 Erie 7166313555

O Neil, Mary M. Rheumatology Buffalo Rheumatology 3055 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166752500

Pone, Entela P. Rheumatology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Saldana, Danilo B. Rheumatology Saldana, Danilo 993 Delaware Ave Buffalo NY 14209 Erie 7168821120

Salvador, Edgardo F. Rheumatology Edgardo F Salvador MD PC 3140 Sheridan Dr Ste 201 Amherst NY 14226 Erie 7168322920

Schulte, Mark E. Rheumatology Robert E Kaprove dba Rheumatology Consultants of WNY PC 3615 Seneca St Ste F West Seneca NY 14224 Erie 7166757376

Tambar, Prem K. Rheumatology Tambar, Prem 585 Delaware St Tonawanda NY 14150 Erie 7166948080

Weingarten, Michael S. Rheumatology Robert E Kaprove dba Rheumatology Consultants of WNY PC 3615 Seneca St Ste F West Seneca NY 14224 Erie 7166757376

Aquilina, Alan T. Sleep Medicine Academic Medicine Services 4893 Transit Rd Depew NY 14043 Erie 7166682543

Aquilina, Alan T. Sleep Medicine Academic Medicine Services 6105 Transit Rd East Amherst NY 140512611 Erie 7163483440

Aquilina, Alan T. Sleep Medicine Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983333

Aquilina, Alan T. Sleep Medicine Academic Medicine Services 462 Grider St Buffalo NY 14215 Erie 7168983375

Aquilina, Alan T. Sleep Medicine Associated Healthcare Systems Inc 462 Grider St Buffalo NY 14215 Erie 7168983375

Aquilina, Alan T. Sleep Medicine Alan Thomas Aquilina MD 6105 Transit Rd East Amherst NY 14051 Erie 7163483435

Aquilina, Alan T. Sleep Medicine Associated Healthcare Systems Inc 1400 Sweethome Rd Buffalo NY 14228 Erie 7168983199

Aquilina, Alan T. Sleep Medicine Academic Medicine Services 310 Sterling Dr Ste 110 Orchard Park NY 14127 Erie 7166754002

Aquilina, Alan T. Sleep Medicine Academic Medicine Services 4511 Harlem Rd Ste 202 Buffalo NY 14221 Erie 7169294654

Augustine, Francis K. Sleep Medicine Mercy Hospital 565 Abbott Rd Buffalo NY 14224 Erie 7168267000

Augustine, Francis K. Sleep Medicine Augustine, Francis 531 Center Rd West Seneca NY 14224 Erie 7166750445

Buscaglia, Anthony J. Sleep Medicine Buscaglia, Anthony 515 Abbott Rd Ste 102 C Buffalo NY 14220 Erie 7168240266

Buscaglia, Anthony J. Sleep Medicine Buscaglia, Anthony 565 ABBOTT RD Buffalo NY 14220 Erie 7168240266

Buscaglia, Anthony J. Sleep Medicine Buscaglia, Anthony 5451 Southwestern Blvd Hamburg NY 14075 Erie 7166493638

Dominik, Jacob Sleep Medicine Sleep Insights Medical Services LLC 760 Dick Rd Buffalo NY 14225 Erie 5853856070

Dominik, Jacob Sleep Medicine Sleep Insights Medical Services LLC 564 Niagara St Buffalo NY 14210 Erie 5853856070

Henderson, Jennifer G. Sleep Medicine Academic Medicine Services 6105 Transit Rd Ste 100 East Amherst NY 14051 Erie 7163483435

Mador, M Jeffery Sleep Medicine Academic Medicine Services 6105 Transit Rd Ste 100 East Amherst NY 14051 Erie 7163483435

Plotkin, Kenneth E. Sleep Medicine Sleep Insights Medical Services LLC 564 Niagara St Buffalo NY 14201 Erie 5853856070

Plotkin, Kenneth E. Sleep Medicine Sleep Insights Medical Services LLC 760 Dick Rd Buffalo NY 14225 Erie 5853856070

Rifkin, Daniel I. Sleep Medicine Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592175

Rifkin, Daniel I. Sleep Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 1491 Sheridan Dr Kenmore NY 14223 Erie 7169237326

Rifkin, Daniel I. Sleep Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 3 Gates Cir Buffalo NY 14209 Erie 7168875337

Rifkin, Daniel I. Sleep Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 219 Bryant St Buffalo NY 14222 Erie 7169237326

Rifkin, Daniel I. Sleep Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 4090 Seneca St West Seneca NY 14224 Erie 7169237326

Rifkin, Daniel I. Sleep Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 1120 Youngs Rd Williamsville NY 14221 Erie 7169237326

Rifkin, Daniel I. Sleep Medicine Daniel I Rifkin Md Pc Dba Sleep Medicine C 640 Ellicott St Buffalo NY 14203 Erie 7169237326

Ten Brock, Eric Sleep Medicine Kaleida Health 100 High St Ste B8 Buffalo NY 14203 Erie 7168597280

Ten Brock, Eric Sleep Medicine Academic Medicine Services 6105 Transit Rd East Amherst NY 14051 Erie 7163483435

Ten Brock, Eric Sleep Medicine Academic Medicine Services 4893 Transit Rd Depew NY 14043 Erie 7163483435

Ten Brock, Eric Sleep Medicine Academic Medicine Services 4511 Harlem Rd Ste 202 Buffalo NY 14226 Erie 7169294654

Ten Brock, Eric Sleep Medicine Academic Medicine Services 310 Sterling Dr Orchard Park NY 14127 Erie 7163483435

Ten Brock, Eric Sleep Medicine Academic Medicine Services 100 High St Buffalo NY 14203 Erie 7168592271

Abramowski, Mary Beth Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Abramowski, Mary Beth Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Abramowski, Mary Beth Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Arth, Sarah J. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Arth, Sarah J. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Austin, Allen A. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Austin, Allen A. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Page 150 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Baker, Kelly A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Baker, Kelly A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Baker, Kelly A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Bamrick, Amy E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Bamrick, Amy E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Bamrick, Amy E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Barnes, Megan M. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Barnes, Megan M. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Barone, Sherrin M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Bauer, Andrea R. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858371

Bauer, Andrea R. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Bauer, Andrea R. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Bonerb, Mary C. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Bonerb, Mary C. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Byrnes, Kerry A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Byrnes, Kerry A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Byrnes, Kerry A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Carr, Justin G. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Carr, Justin G. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Carr, Justin G. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Caruso, Mary E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Caruso, Mary E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Caruso, Mary E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Chambers, Lindsay A. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Buffalo NY 14221 Erie 7163621552

Chambers, Lindsay A. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719883

Ciepiela, Lisa M. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Ciepiela, Lisa M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Ciepiela, Lisa M. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Cinotti, Theresa M. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomed Educ Bldg Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Collins, Melinda M. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Collins, Melinda M. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7168719883

Czwojdak, Allison Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Czwojdak, Allison Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Czwojdak, Allison Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Delisanti, Sonia M. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Delisanti, Sonia M. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Delisanti, Sonia M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Deroo, William E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Deroo, William E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Deroo, William E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Dineen, Sarah E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Dineen, Sarah E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Dineen, Sarah E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Dodman, Danielle F. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Dodman, Danielle F. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Dodman, Danielle F. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Dombrowski, Jennifer L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Dombrowski, Jennifer L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Dombrowski, Jennifer L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Dunwoodie Ryan, Rosemary Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Emel, Lora Speech Language Path SPEECH LANGUAGE AND COMMUNICATION ASSOCIATES 5544 Main St Williamsville NY 14221 Erie 7165803976

Farewell, Martha J. Speech Language Path Aspire of WNY Inc 7 Community Dr Cheektowaga NY 14225 Erie 7165055636

Felker, Monika Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Felker, Monika Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334881

Felker, Monika Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317603

Felker, Monika Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Felker, Monika Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Felsenfeld, Susan Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Educ Bldg 3435 Main St Buffalo NY 14214 Erie 7168293930

Filippini, Erin L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Filippini, Erin L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Filippini, Erin L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Flynn, Bridget O. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Flynn, Bridget O. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Fox, Elizabeth A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Fox, Elizabeth A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Fox, Elizabeth A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Page 151 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Fuhrmann, Karen E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Fuhrmann, Karen E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Fuhrmann, Karen E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Furlani, Mary Anne Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Furlani, Mary Anne Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Furlani, Mary Anne Speech Language Path Hearing & Speech Center of WNY 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Galvez, Michelle A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Galvez, Michelle A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Galvez, Michelle A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Goodwill, Laurie E. Speech Language Path Aurora Audiology & Speech Assoc Inc 97 Hamburg St East Aurora NY 14052 Erie 7166526464

Harig, Pamela A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Harig, Pamela A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Harig, Pamela A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Harris, Natalie A. Speech Language Path Aspire of WNY Inc 2356 N Forest Rd Getzville NY 14068 Erie 7165055720

Harris, Natalie A. Speech Language Path Aspire of WNY Inc 7 Community Dr Buffalo NY 14225 Erie 7165055630

Haskill, Lilian A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Haskill, Lilian A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Haskill, Lilian A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Hemming, Jillian L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Holtz, Elizabeth Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Holtz, Elizabeth Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Holtz, Elizabeth Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Hughes, Carrie A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Hughes, Carrie A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Hughes, Carrie A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Jakubowski, Keri Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Jakubowski, Keri Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Jakubowski, Keri Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Johel, Patrick M. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Johel, Patrick M. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Jones, Heather A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Jones, Heather A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Jones, Heather A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Kelley, Ryan P. Speech Language Path Aspire of WNY Inc 101 Oak St Buffalo NY 14203 Erie 7168564202

Kelley, Ryan P. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Kelley, Ryan P. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Kelley, Ryan P. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Kennedy, Sara A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Kennedy, Sara A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Kennedy, Sara A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Kestel, Casandra M. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Kestel, Casandra M. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Kestel, Casandra M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Knight, Margaret A. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Krstevski, Mary D. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Krstevski, Mary D. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Krstevski, Mary D. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Kubik, Anita R. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Kubik, Anita R. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Kubik, Anita R. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Kubik, Anita R. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Kubik, Anita R. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Kuna, Nicole R. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Kuna, Nicole R. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Kuna, Nicole R. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Kuzara, Kimberlee L. Speech Language Path South Shore Comprehensive Therapies 1025 Ridge Rd Lackawanna NY 14218 Erie 7168224781

Larkin, Sarah B. Speech Language Path Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Liberta, Christina L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Liberta, Christina L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Liberta, Christina L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Logel, Amy L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Logel, Amy L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Logel, Amy L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Loss, Kelli L. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Loss, Kelli L. Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Williamsville NY 14221 Erie 7163621552

Lucarelli, Monica L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Page 152 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Lucarelli, Monica L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Lucarelli, Monica L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Lukasiewicz, Patricia Speech Language Path Aurora Audiology & Speech Assoc Inc 97 Hamburg St East Aurora NY 14052 Erie 7166526464

Lyle, Katherine Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Lyle, Katherine Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Lyle, Katherine Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Maldonado III, Camilo Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Kenmore NY 14217 Erie 7168719883

Maloy, Margaret S. Speech Language Path Aspire of WNY Inc 101 Oak St Buffalo NY 14203 Erie 7168564202

Manning, Allison Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Manning, Allison Speech Language Path Aspire of WNY Inc 101 Oak St Buffalo NY 14203 Erie 7168564202

Manning, Allison Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Manning, Allison Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Marsack, Sarah F. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Marsack, Sarah F. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

McnNamara, Rachel E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

McnNamara, Rachel E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

McnNamara, Rachel E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Mehltretter, Alyssa D. Speech Language Path SPEECH LANGUAGE AND COMMUNICATION ASSOCIATES 5544 Main St Williamsville NY 14221 Erie 7165803967

Merrell, Sara Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 2900 Delaware Ave Buffalo NY 14217 Erie 7162719883

Merrell, Sara Speech Language Path Diversified Services for OT PT SLP and Audiology LLC 17 Limestone Dr Ste 5 Buffalo NY 14221 Erie 7163621552

Miller, Steven R. Speech Language Path Buffalo Hearing & Speech 14026 UNION DR Buffalo NY 14224 Erie 7165581105

Miller, Steven R. Speech Language Path Buffalo Hearing & Speech 5225 SHERIDAN DR Buffalo NY 14221 Erie 7162048680

Miller, Steven R. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Minervini, Cara Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Minervini, Cara Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Minervini, Cara Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Mobley, Elizabeth Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Mobley, Elizabeth Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Mobley, Elizabeth Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Naeger, Rose M. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 3435 Main St Beb Rm 50 Buffalo NY 14214 Erie 7168293980

Neth, Barbara A. Speech Language Path Barbara Ann Neth 109 Trinity Pl Buffalo NY 14201 Erie 7164811319

O'Connor, Jill M. Speech Language Path Jill M O'Connor 63 Larned Ln Orchard Park NY 14127 Erie 7165600536

Orlando Parker, Ann C. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Orlando Parker, Ann C. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Ozark, Joanne E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Ozark, Joanne E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Ozark, Joanne E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Pasquale, Lori A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Pasquale, Lori A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858371

Pasquale, Lori A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Pereles, Lauren M. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Pereles, Lauren M. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Pereles, Lauren M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Petrozzi, Anne E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Petrozzi, Anne E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Petrozzi, Anne E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Piper, Katie A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Piper, Katie A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Piper, Katie A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Pozzuto, Anthony J. Speech Language Path VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Pozzuto, Anthony J. Speech Language Path VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Privitera, Kiera A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Privitera, Kiera A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Privitera, Kiera A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Puglisi, Kristen M. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Puglisi, Kristen M. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Puglisi, Kristen M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Ragusa, Caroline A. Speech Language Path SPEECH LANGUAGE AND COMMUNICATION ASSOCIATES 5544 Main St Williamsville NY 14221 Erie 7165803976

Rauber, Sandra K. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Rauber, Sandra K. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Rauber, Sandra K. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Ricciardi, Karen M. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Ricciardi, Karen M. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166337503

Richardson, Kelly C. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Educ Bldg Buffalo NY 14214 Erie 7168293980

Ringholz, Donna M. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Beb Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Ritter Schmidt, Dona H. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 3435 Main St 52 Biomedical Education Bldg Buffalo NY 14214 Erie 7168293980

Page 153 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Ritter Schmidt, Dona H. Speech Language Path Delaware Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Rivera, Joelle A. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Rivera, Joelle A. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Rivera, Joelle A. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Rumfola, Jennifer A. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Education Bldg Buffalo NY 14214 Erie 7168293930

Sawyer, Sarah Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Sawyer, Sarah Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Sawyer, Sarah Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Sciarrino, Maralyn Speech Language Path Mount Mercy Speech Center 625 Abbott Rd Buffalo NY 14220 Erie 7168255318

Sellers, Carol A. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Beb Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Shairi, Zahra N. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Shairi, Zahra N. Speech Language Path Buffalo Hearing & Speech 1026 UNION RD Buffalo NY 14224 Erie 7165581105

Shairi, Zahra N. Speech Language Path Buffalo Hearing & Speech 5225 SHERIDAN DR Buffalo NY 14221 Erie 7162048680

Sheehan, Carrie Ann Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Cheektowaga NY 14225 Erie 7165581105

Sheehan, Carrie Ann Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Sheehan, Carrie Ann Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Smaldino, James M. Speech Language Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Smith, Emilie Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Sonnenberg, Joseph P. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858371

Sonnenberg, Joseph P. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Sonnenberg, Joseph P. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Stachowski, Claudia C. Speech Language Path Stachowski, Claudia 8899 Main St Williamsville NY 14221 Erie 7168602396

Stachowski, Claudia C. Speech Language Path Stachowski, Claudia 5280 Goodrich Rd Clarence NY 14031 Erie 7168602396

Stando, Cynthia Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Williamsville NY 14221 Erie 7166317503

Stando, Cynthia Speech Language Path Hearing & Speech Center of WNY 4063 N Buffalo Rd Ste 3 Orchard Park NY 14127 Erie 7168334884

Stando, Cynthia Speech Language Path Hearing & Speech Center of WNY 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Stando, Cynthia Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Steger, Meghan L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Steger, Meghan L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Steger, Meghan L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Stohl, Amy S. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Stohl, Amy S. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Stohl, Amy S. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Stranahan, Angela E. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Stranahan, Angela E. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Stranahan, Angela E. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Sumbrum, Amy L. Speech Language Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Swartzenberg, Gretchen A. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Education Bldg Buffalo NY 14214 Erie 7168293980

Sweeney, Ashley L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Sweeney, Ashley L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Sweeney, Ashley L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Sweet, Kristin N. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Sweet, Kristin N. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Sweet, Kristin N. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Szymula, Annette S. Speech Language Path Hearing and Speech of WNY PLLC 2545 Sheridan Dr Tonawanda NY 14150 Erie 7168334884

Szymula, Annette S. Speech Language Path Hearing and Speech of WNY PLLC 2733 Wehrle Dr Ste 200 Buffalo NY 14221 Erie 7166317503

Terhune, Leeann Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Terhune, Leeann Speech Language Path Buffalo Hearing & Speech 1026 UNION RD West Seneca NY 14224 Erie 7165581105

Terhune, Leeann Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Thiel, Carrie E. Speech Language Path Elmwood Health Center 2128 Elmwood Ave Buffalo NY 14207 Erie 7168744500

Treutlein, Tami D. Speech Language Path SPEECH LANGUAGE AND COMMUNICATION ASSOCIATES 5544 Main St Williamsville NY 14221 Erie 7165803976

Verrico, Stephanie A. Speech Language Path UB speech & Hearing Center 52 Biomed Educ Bldg Rm 50 3435 Main St Buffalo NY 14214 Erie 7168293980

Vinciguerra, Jaclyn M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Vinciguerra, Jaclyn M. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Vinciguerra, Jaclyn M. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Vogel, Kristy L. Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Vogel, Kristy L. Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Vogel, Kristy L. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Wachowiak, Lindsay M. Speech Language Path Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Warner, Sharon Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Warner, Sharon Speech Language Path Buffalo Hearing & Speech 1026 Union Rd Buffalo NY 14224 Erie 7165581105

Warner, Sharon Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Buffalo NY 14221 Erie 7162048680

Weber, Nicole M. Speech Language Path Univ at Buffalo Speech-Language and Hearing Clinic Inc 52 Biomedical Education Bldg Buffalo NY 14214 Erie 7168293930

Wojnowski, Diane M. Speech Language Path Aspire of WNY Inc 50 E North St Buffalo NY 14203 Erie 7168858318

Wojnowski, Diane M. Speech Language Path Aspire of WNY Inc 7 Community Dr Cheektowaga NY 14225 Erie 7165055630

Wojnowski, Diane M. Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Page 154 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Wojnowski, Diane M. Speech Language Path Aspire of WNY Inc 101 Oak St Buffalo NY 14203 Erie 7168564204

Wojnowski, Diane M. Speech Language Path The Resource Center 50 E North St Buffalo NY 14203 Erie 7168858318

Wojnowski, Diane M. Speech Language Path The Resource Center 7 Community Dr Cheektowaga NY 14225 Erie 7165055630

Worley, Sara M. Speech Language Path Worley, Sara M. 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Worley, Sara M. Speech Language Path Worley, Sara M. 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Worley, Sara M. Speech Language Path Buffalo Hearing & Speech 50 East North St Buffalo NY 14203 Erie 7168858318

Young, Ellie Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Young, Ellie Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Young, Ellie Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Zielinski, Dawn Speech Language Path Buffalo Hearing & Speech 1026 Union Rd West Seneca NY 14224 Erie 7165581105

Zielinski, Dawn Speech Language Path Buffalo Hearing & Speech 5225 Sheridan Dr Williamsville NY 14221 Erie 7162048680

Zielinski, Dawn Speech Language Path Buffalo Hearing & Speech 50 E North St Buffalo NY 14203 Erie 7168858318

Fung, Tat S. Spinal Cord Injury Med Exigence Medical of New York 462 Grider St Buffalo NY 14215 Erie 7179893000

Fung, Tat S. Spinal Cord Injury Med University Physical Medicine & Rehab 462 Grider St Buffalo NY 14215 Erie 7168983000

Fung, Tat S. Spinal Cord Injury Med Rehabilitation Physician Services of Erie County PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Livecchi, Mark A. Spinal Cord Injury Med Grider Medical Services PLLC 462 Grider St Buffalo NY 14215 Erie 7162044500

Freitas, Michael S. Sports Medicine Highgate Medical Group 3950 E Robinson Rd Ste 207 West Amherst NY 14228 Erie 7165641111

Freitas, Michael S. Sports Medicine University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7162043201

Freitas, Michael S. Sports Medicine University Orthopaedics Services Inc 5959 Big Tree Rd Orchard Park NY 14127 Erie 7162043200

Hudzinski, Lori D. Sports Medicine Bertrand Chaffee Hospital 224 E Main St Springville NY 14141 Erie 7165922871

Jain, Rajiv K. Sports Medicine Sheridan Medical Group LLP 1491 Sheridan Dr Tonawanda NY 14217 Erie 7163324476

Jain, Rajiv K. Sports Medicine University Orthopaedics Services Inc 1026 Union Rd West Seneca NY 14224 Erie 7162043200

Jain, Rajiv K. Sports Medicine University Orthopaedics Services Inc 160 Farber Hall Buffalo NY 14214 Erie 7162043200

Jain, Rajiv K. Sports Medicine University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Jain, Rajiv K. Sports Medicine University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Jordan, Michael R. Sports Medicine Genesee Valley Group Health Association Lifetime Health 1185 Sweethome Rd Amherst NY 14226 Erie 7166890040

Leddy, John J. Sports Medicine University Orthopaedics Services Inc 160 Farber Hall 3435 Main St Buffalo NY 14214 Erie 7168292070

Leddy, John J. Sports Medicine University Orthopaedics Services Inc 4949 Harlem Rd Amherst NY 14226 Erie 7168293670

Leddy, John J. Sports Medicine University Orthopaedics Services Inc 4180 Abbott Rd Orchard Park NY 14127 Erie 7166484321

Lorenc, Todd M. Sports Medicine Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Lorenc, Todd M. Sports Medicine Excelsior Orthopaedics Llp 240 Red Tail Ste 1 and 2 Orchard Park NY 14127 Erie 7162509999

Matuszak, Jason M. Sports Medicine Excelsior Orthopaedics Llp 3925 Sheridan Dr Amherst NY 14226 Erie 7162509999

Matuszak, Jason M. Sports Medicine Excelsior Orthopaedics Llp 240 Red Tail Ste 1 and 2 Orchard Park NY 14127 Erie 7162509999

OKeeffe, David A. Sports Medicine Buffalo Medical Group 3345 Southwestern Blvd Orchard Park NY 14127 Erie 7166564805

Roberto, Craig M. Sports Medicine Frank J Schlehr MD PC 15 S Forest Rd Williamsville NY 14221 Erie 7166261824

Sodhi, Vikram S. Sports Medicine General Physician PC 7020 Erie Rd Ste 5 Derby NY 14047 Erie 7165627064

Sodhi, Vikram S. Sports Medicine General Physician PC 517 Sunset Dr Hamburg NY 14075 Erie 7166462590

Teeter, Jennifer M. Sports Medicine Buffalo Orthopaedic Group LLP 192 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7162041101

Adams, Timothy M. Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Alosi, Julie A. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Alvarez Perez, Julio A. Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 100 High St Ste A2 Buffalo NY 14203 Erie 7168593301

Alvarez Perez, Julio A. Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 4600 Main St Ste 100 Amherst NY 14226 Erie 7168593301

Alvarez Perez, Julio A. Surgery South Towns Surgical Associates Pc 310 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Alvarez Perez, Julio A. Surgery South Towns Surgical Associates Pc 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166757730

Alvarez Perez, Julio A. Surgery Our Lady Of Victory Hospital 310 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Alvarez Perez, Julio A. Surgery Alvarez MD and Leary MD PC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

Alvarez Perez, Julio A. Surgery Surgical Associates Diagnostics PLLC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

Armstrong, Robert S. Surgery Surgical Associates Of Western Ny Pc 550 Orchard Park Rd Ste A103 West Seneca NY 14224 Erie 7166775500

Baker, Jon M. Surgery Surgical Associates of SGI PLLC 224 E Main St Springville NY 14141 Erie 7167940040

Barone, Steven M. Surgery Delaware Surgical Grp Pc 3 Gates Cir Buffalo NY 14209 Erie 7166369004

Barone, Steven M. Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Barone, Steven M. Surgery Delaware Surgical Grp Pc 1150 Youngs Rd Ste 202 Williamsville NY 14221 Erie 7166369004

Barone, Steven M. Surgery Kaleida Health 100 High St D3 Colon Rectal Clinic Buffalo NY 14203 Erie 7168592524

Bauer, Ronald L. Surgery RPCI Oncology PC 199 Park Club Ln Ste 100 Williamsville NY 14221 Erie 7163326834

Bauer, Ronald L. Surgery Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Berndtson, Jeffrey W. Surgery Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166564826

Blessios, George A. Surgery George A Blessios 515 Abbott Rd Ste 310 Buffalo NY 14220 Erie 7168222400

Blessios, George A. Surgery Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Bloomberg, Richard D. Surgery Surgical Associates Of Western Ny Pc 550 Orchard Pk Rd Ste A103 West Seneca NY 14224 Erie 7166775500

Bloomberg, Richard D. Surgery Surgical Associates Of Western Ny Pc 2780 Delaware Ave Ste 201 Kenmore NY 14217 Erie 7166775500

Bloomberg, Richard D. Surgery Surgical Associates Of Western Ny Pc 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7166775500

Brewer, Jeffrey J. Surgery University at Buffalo Surgeons Inc 462 Grider St Dept of Surgery Buffalo NY 14215 Erie 7168985186

Brewer, Jeffrey J. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Brewer, Jeffrey J. Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Buckley Jr, Richard J. Surgery Amherst Surgical Assoc Pc 4231 Maple Rd Amherst NY 14226 Erie 7168379111

Burke, Mark S. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Page 155 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Burke, Mark S. Surgery Delaware Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Burke, Mark S. Surgery Terrace View 2157 Main St Buffalo NY 14214 Erie 7168621000

Butler, Bryan N. Surgery Kaleida Health 100 High St D3 Buffalo NY 14203 Erie 7168592524

Butler, Bryan N. Surgery Kaleida Health 6255 Sheridan Dr Ste 304 Williamsville NY 14221 Erie 7168592524

Butler, Bryan N. Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578880

Butsch, John L. Surgery University at Buffalo Surgeons Inc 100 High St Dept of Surgery Buffalo NY 14209 Erie 7168594024

Butsch, John L. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591168

Butsch, John L. Surgery General Physician PC 210 E Main St Springville NY 14141 Erie 7165923600

Butsch, John L. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Cance, William G. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Cappuccino, Helen Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Caruana, Joseph A. Surgery Terrace View 2157 Main St Buffalo NY 14214 Erie 7168621000

Caruana, Joseph A. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Caruana, Joseph A. Surgery Synergy Bariatrics 30 N Union Rd Ste 104 Williamsville NY 14221 Erie 7165653990

Cavaretta, Mark Surgery Terrace View 2157 Main St Buffalo NY 14214 Erie 7168621000

Cavaretta, Mark Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Cavaretta, Mark Surgery Synergy Bariatrics 30 N Union Rd Ste 104 Williamsville NY 14221 Erie 7165653990

Chia, Kimbo B. Surgery Kimbo Chia MD PC 564 Niagara St Buffalo NY 14201 Erie 7163320678

Chia, Kimbo B. Surgery Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482180

Chia, Kimbo B. Surgery Buffalo Emergency Associates 1 John James Audubon Pkwy Buffalo NY 14228 Erie 7162044500

Chopko, Michael S. Surgery University at Buffalo Surgeons Inc 1150 Youngs Rd Ste 108 Buffalo NY 14221 Erie 7162104038

Chopko, Michael S. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Chopko, Michael S. Surgery University at Buffalo Surgeons Inc 462 Grider St Dept of Surgery Buffalo NY 14215 Erie 7168985186

Cohan, David M. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Cooper, Clairice A. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Cooper, Clairice A. Surgery University at Buffalo Surgeons Inc 462 Grider St Miller Bldg Buffalo NY 14215 Erie 7168985186

Dawli, Naim A. Surgery Dawli, Naim 12845 Broadway Alden NY 14004 Erie 7169374540

Dawli, Naim A. Surgery Dawli, Naim 2121 Main St Buffalo NY 14214 Erie 7168342400

De Perio, Jeffrey A. Surgery De Perio, Jeffrey 571 Terrace Blvd Depew NY 14043 Erie 7166836737

Demmy, Todd L. Surgery Kaleida Health 100 High St B-8 The Heart and Lung Center Buffalo NY 14203 Erie 7168597280

Doerr, Ralph J. Surgery Doerr, Ralph 81 Deer Run Buffalo NY 14221 Erie 5857480651

Doerr, Ralph J. Surgery Aquinas Surgical Associates PC 81 Deer Run Buffalo NY 14221 Erie 5857980651

Eckhert III, Kenneth H. Surgery South Towns Surgical Associates Pc 1000 Youngs Rd Ste 105 Williamsville NY 14221 Erie 7166757730

Eckhert III, Kenneth H. Surgery South Towns Surgical Associates Pc 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166757730

Eckhert III, Kenneth H. Surgery South Towns Surgical Associates Pc 310 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Evans, Evan J. Surgery Delaware Surgical Grp Pc 1150 Youngs Rd Ste 202 Williamsville NY 14221 Erie 7166369004

Falvo, Mark A. Surgery Delaware Surgical Grp Pc 3 Gates Cir Buffalo NY 14209 Erie 7166369004

Falvo, Mark A. Surgery Kaleida Health 100 High St D3 Colon Rectal Clinic Buffalo NY 14203 Erie 7168592524

Falvo, Mark A. Surgery Delaware Surgical Grp Pc 1150 Youngs Rd Ste 202 Williamsville NY 14221 Erie 7166369004

Falvo, Mark A. Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Fazili, Mohamad Y. Surgery Fazili, Mohamad 3469 Harlem Rd Cheektowaga NY 14225 Erie 7168333008

Francescutti, Valerie A. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Gibbs, John F. Surgery University at Buffalo Surgeons Inc 100 High St Dept of Surgery Buffalo NY 14203 Erie 7168592268

Gibbs, John F. Surgery Kaleida Health 100 high St D 3 BHG Surgery Clinic Buffalo NY 14240 Erie 7168592524

Glick, Philip L. Surgery University at Buffalo Pediatric Surgical 219 Bryant St Dept Of Ped Surg Buffalo NY 14222 Erie 7168787449

Glick, Philip L. Surgery University at Buffalo Surgeons Inc 3580 Sheridan Dr Amherst NY 14226 Erie 7168593371

Graff, Jonathan A. Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Guo, Weidun A. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Guo, Weidun A. Surgery University at Buffalo Surgeons Inc 462 Grider St Miller Bldg univ at Bflo Buffalo NY 14215 Erie 7168985186

Hassett, James M. Surgery University at Buffalo Surgeons Inc 3 Gates Cir Dept Of Surg Buffalo NY 14209 Erie 7168874224

Hassett, James M. Surgery University at Buffalo Surgeons Inc 100 High St Dept Of Surg Buffalo NY 14203 Erie 7168593556

Hennon, Mark W. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Hickey, Donald D. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592469

Hickey, Donald D. Surgery Kaleida Health 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Hill, Hank C. Surgery Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY 14203 Erie 7168482000

Hochwald, Steven N. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Hodge, Robert W. Surgery Great Lakes Surgical Associates PC 2914 Elmwood Ave Kenmore NY 14217 Erie 7164346141

Hoffman, Aaron B. Surgery General Physician PC 210 E Main St Springville NY 14141 Erie 7165923600

Hoffman, Aaron B. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592230

Hohn, David C. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Huang, Miriam Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Huff, Devon M. Surgery Delaware Surgical Grp Pc 1150 Youngs Rd Ste 202 Williamsville NY 14221 Erie 7166369004

Huff, Devon M. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168984800

Hughes, Melissa L. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Ibrahim, Mohamed M. Surgery Niagara Falls Memorial Medical Center 180 Rivermist Dr Buffalo NY 14202 Erie 7162784000

Johnson, Rurik C. Surgery Surgical Associates Of Western Ny Pc 550 Orchard Park Rd Ste A 103 Buffalo NY 14224 Erie 7166775500

Page 156 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Johnson, Rurik C. Surgery Surgical Associates Of Western Ny Pc 2780 Delaware Ave Kenmore NY 14217 Erie 7166775500

Johnson, Rurik C. Surgery Surgical Associates Of Western Ny Pc 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7166775500

Johnson, Rurik C. Surgery Surgical Associates Of Western Ny Pc 1040 Union Rd West Seneca NY 14224 Erie 7166775500

Jordan, Jeffrey M. Surgery University at Buffalo Surgeons Inc 462 Grider St Miller Bldg Buffalo NY 14215 Erie 7168985186

Jordan, Jeffrey M. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Kane III, John M. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Karamanoukian, Hratch L. Surgery Advanced Cardiac Surgical Assoc Pllc 9091 Main St Clarence NY 14031 Erie 7166267700

Karamanoukian, Hratch L. Surgery Advanced Cardiac Surgical Assoc Pllc 5225 Sheridan Dr Williamsville NY 14221 Erie 7168393638

Kassavin, Daniel S. Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 4949 Harlem Rd Ste 302 Amherst NY 14228 Erie 7168372400

Kassavin, Daniel S. Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 2121 Main St Ste 316 Buffalo NY 14214 Erie 7168372400

Kukar, Moshim Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kumar, Shicha Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kuvshinoff II, Boris W. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Laftavi, Mark R. Surgery Terrace View 462 Grider St 10th Fl Buffalo NY 14215 Erie 7168985001

Lall, Purandath Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Leary III, Daniel A. Surgery Surgical Associates Diagnostics PLLC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

Leary III, Daniel A. Surgery Alvarez MD and Leary MD PC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

Leary III, Daniel A. Surgery Surgical Associates Of Western Ny Pc 3030 Orchard Park Dr Ste B Buffalo NY 14224 Erie 7166718393

Leary III, Daniel A. Surgery Surgical Associates Of Western Ny Pc 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7166775500

Leary III, Daniel A. Surgery Surgical Associates Of Western Ny Pc 305 Main St East Aurora NY 14052 Erie 7166775500

Leary III, Daniel A. Surgery Surgical Associates Of Western Ny Pc 1040 Union Rd West Seneca NY 14224 Erie 7166775500

Leary III, Daniel A. Surgery Surgical Associates Diagnostics PLLC 462 Grider St Rm 1283 1 Buffalo NY 14215 Erie 7168983022

Leary III, Daniel A. Surgery Surgical Associates Of Western Ny Pc 37 Hamburg St East Aurora NY 14052 Erie 7166775500

Leary III, Daniel A. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983022

Lico, Serrie C. Surgery Lico, Serrie C. 565 Abbott Rd Buffalo NY 14220 Erie 7168217714

Lico, Serrie C. Surgery Lico, Serrie C. 515 Abbott Rd Ste 101 Buffalo NY 14220 Erie 7168217714

Lindfield, Vivian L. Surgery Vivian L Lindfield MD PC 462 Grider St Buffalo NY 14215 Erie 7168983000

Lindfield, Vivian L. Surgery Vivian L Lindfield MD PC 219 Bryant St Buffalo NY 14222 Erie 7168787000

Lindfield, Vivian L. Surgery Vivian L Lindfield MD PC 2157 Main St Buffalo NY 14214 Erie 7168621000

Lindfield, Vivian L. Surgery Vivian L Lindfield MD PC 3915 Sheridan Dr Buffalo NY 14226 Erie 7166327465

Lindfield, Vivian L. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Loree, Thom R. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Loree, Thom R. Surgery Delaware Medical Group 1083 Delaware Ave Buffalo NY 14209 Erie 7168821023

Lukan, James K. Surgery University at Buffalo Surgeons Inc 462 Grider St Dept Of Surgery Buffalo NY 14215 Erie 7168985186

Lukan, James K. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Mitchell, Michael J. Surgery Mitchell, Michael 2809 Wehrle Dr Ste 13 Buffalo NY 14221 Erie 7166320006

Moon, Wong K. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Moore, George B. Surgery Moore, George 3112 Sheridan Dr Amherst NY 14226 Erie 7168319435

Moore, George B. Surgery Moore, George 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Moore, George B. Surgery Sherban Orthopaedics and Spine Surgery PLLC 2914 Elmwood Ave Kenmore NY 14217 Erie 7164476310

Moore, George B. Surgery Moore, George 6020 Seufert Rd Orchard Park NY 14127 Erie 7166498739

Moore, Molly E. Surgery Kaleida Health 100 High St D Basement Buffalo NY 14203 Erie 7168592175

Moore, Molly E. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Nava, Hector R. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Nguyen, Toan T. Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Nguyen, Toan T. Surgery Vivian L Lindfield MD PC 3915 Sheridan Dr Amherst NY 14226 Erie 7166327465

Nguyen, Toan T. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Nguyen, Toan T. Surgery Vivian L Lindfield MD PC 3050 Orchard Park Rd West Seneca NY 14224 Erie 7166327465

Noor, Sonya S. Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 4600 Main St Ste 100 Amherst NY 14226 Erie 7168593301

Noor, Sonya S. Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 100 High St Buffalo NY 14203 Erie 7166923302

Nurkin, Steven J. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Nwogu, Chukwumere E. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

O Donnell, Katherine A. Surgery CCS Oncology PC 55 Spindrift Dr Ste 220 Williamsville NY 14221 Erie 7166266300

Oxenberg, Jacqueline C. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Oyasiji, Tolutope O. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Padmanabha, Bhavansa Surgery Padmanabha, Bhavansa 2950 Elmwood Ave Room 5022 Buffalo NY 14217 Erie 7164476629

Padmanabha, Bhavansa Surgery Padmanabha, Bhavansa 63 Main St Akron NY 14001 Erie 7165422754

Painton, Joseph F. Surgery General Physician PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Painton, Joseph F. Surgery Painton, Joseph 8600 Sheridan Dr Williamsville NY 14221 Erie 7166321282

Panchal, Ajay N. Surgery CCS Oncology PC 350 Alberta Dr Amherst NY 14226 Erie 7168337112

Panchal, Narhari M. Surgery CCS Oncology PC 350 Alberta Dr Amherst NY 14226 Erie 7168337112

Panchal, Narhari M. Surgery Panchal, Narhari 350 Alberta Dr Amherst NY 14226 Erie 7168337112

Papenfuss, Wesley A. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Patel, Sunil K. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168592352

Patel, Sunil K. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Patterson, Daniel J. Surgery South Towns Surgical Associates Pc 4855 Camp Rd Hamburg NY 14075 Erie 7166757730

Page 157 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Patterson, Daniel J. Surgery South Towns Surgical Associates Pc 310 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Patterson, Daniel J. Surgery South Towns Surgical Associates Pc 1000 Youngs Rd Ste 105 Williamsville NY 14221 Erie 7166757730

Pell, Michael A. Surgery Michael A Pell MD PC 700 Michigan Ave Buffalo NY 14203 Erie 7168403385

Peyser, Michael B. Surgery CCS Oncology PC 55 Spindrift Ste 220 Williamsville NY 14221 Erie 7166266300

Pham, Dang T. Surgery Buffalo Minimally Invasive Weight Loss Surgical Solutio 2625 Harlem Rd Ste 160 Cheektowaga NY 14225 Erie 7168930333

Posner, Alan R. Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168591168

Posner, Alan R. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983325

Posner, Alan R. Surgery University at Buffalo Surgeons Inc 100 High St Dept Of Surg Buffalo NY 14203 Erie 7168593196

Posner, Alan R. Surgery General Physician PC 210 E Main St Springville NY 14141 Erie 7165923600

Rade, Michael P. Surgery Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Rade, Michael P. Surgery Michael P. Rade, MD PC 550 Center Rd West Seneca NY 14224 Erie 7166751414

Rade, Michael P. Surgery South Towns Surgical Associates Pc 310 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Rade, Michael P. Surgery Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Ralabate, Joseph A. Surgery Mercy Hospital 2875 Union Rd Ste 8 Cheektowaga NY 14227 Erie 7166510911

Ralabate, Joseph A. Surgery Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Rao, Madhuranath Surgery Rao, Madhuranath 2095 Kensington Ave Amherst NY 14226 Erie 7168680087

Rasmusson, Timothy R. Surgery Surgical Associates Of Western Ny Pc 550 Orchard Pk Rd Ste A103 Buffalo NY 14224 Erie 7166775500

Rasmusson, Timothy R. Surgery Surgical Associates Of Western Ny Pc 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7166775500

Rasmusson, Timothy R. Surgery Surgical Associates Of Western Ny Pc 2780 Delaware Ave Kenmore NY 14217 Erie 7166775500

Rivero, Mariel Surgery University at Buffalo Surgeons Inc 100 High St Dept of Surgery 7th Fl Buffalo NY 14203 Erie 7168594225

Sabir, Mohammed Surgery Western New York Medical 4979 Harlem Rd Amherst NY 14226 Erie 7169234380

Savo, Anthony M. Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Savo, Anthony M. Surgery Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Scarbinsky, Aislinn M. Surgery South Towns Surgical Associates Pc 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166757730

Scarbinsky, Aislinn M. Surgery South Towns Surgical Associates Pc 310 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Schratz, Jeffrey J. Surgery Great Lakes Surgical Associates PC 2914 Elmwood Ave Kenmore NY 14217 Erie 7164346141

Sharma, Rajeev Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168985001

Siddiqui, M Yusuf A. Surgery M Yusuf Siddiqui Md 2178 Main St Buffalo NY 14214 Erie 7168388488

Siddiqui, M Yusuf A. Surgery Sisters of Charity Hospital : St Joseph Campus 1595 Bailey Ave Buffalo NY 14212 Erie 7168938550

Silva, Meliton B. Surgery Amherst Surgical Assoc Pc 4231 Maple Rd Buffalo NY 14226 Erie 7168379111

Singla, Smit Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Skitzki, Joseph J. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Staggers Deberny, Joy A. Surgery Staggers-Deberny, Joy 3560 N Buffalo Rd Orchard Park NY 14127 Erie 7166250050

Staggers Deberny, Joy A. Surgery Staggers-Deberny, Joy 11500 Transit Rd East Amherst NY 14051 Erie 7166250050

Steinig, Jeffrey P. Surgery J Steinig MD PLLC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

Taheri, Hamed Surgery Alvarez MD and Leary MD PC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

Talhouk, Akram S. Surgery Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7168578648

Talhouk, Akram S. Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578800

Thirunavukarasu, Pragatheeshwar Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Thomas Jr, Rexford L. Surgery Southgate Medical Group LLP 1026 Union Rd West Seneca NY 14224 Erie 7167120851

Thomas Jr, Rexford L. Surgery Southgate Medical Group LLP 112 Olean Rd East Aurora NY 14052 Erie 7167120851

Tuttle, Rebecca M. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Walborn, David M. Surgery David M Walborn MD PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Walborn, David M. Surgery David M Walborn MD PC 2799 Sheridan Dr Tonawanda NY 14150 Erie 7168374466

Walborn, David M. Surgery David M Walborn MD PC 893 Colvin Blvd Kenmore NY 14217 Erie 7168734406

Walborn, David M. Surgery David M Walborn MD PC 1503 Military Rd Kenmore NY 14217 Erie 7164476600

Walborn, David M. Surgery David M Walborn MD PC 193 S Union Rd Williamsville NY 14221 Erie 7162761900

Walcott, Roger Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 2121 Main St Ste 316 Buffalo NY 14214 Erie 7168372400

Walcott, Roger Surgery Walcott, Roger 4949 Harlem Rd Ste 302 Amherst NY 14228 Erie 7168372400

Wiles III, Charles E. Surgery University at Buffalo Surgeons Inc 462 Grider St Dk Miller Bldg Buffalo NY 14215 Erie 7168985186

Wiles III, Charles E. Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Wiles, John B. Surgery Wiles, John 2625 Harlem Rd Ste 140 Buffalo NY 14225 Erie 7168930221

Wilkinson, Neal W. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Yendamuri, Saikrishna Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168453516

Young, Jessica S. Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Zerfas, Dorene K. Surgery South Towns Surgical Associates Pc 4855 Camp Rd Ste 100 Hamburg NY 14075 Erie 7166757730

Zerfas, Dorene K. Surgery South Towns Surgical Associates Pc 301 Sterling Dr Ste 105 Orchard Park NY 14127 Erie 7166757730

Demmy, Todd L. Surgical Critical Care Kaleida Health 100 High St B-8 The Heart and Lung Center Buffalo NY 14203 Erie 7168597280

Flynn Jr, William J. Surgical Critical Care Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Flynn Jr, William J. Surgical Critical Care University at Buffalo Surgeons Inc 462 Grider St Miller Bldg Univ at Bflo Surg Buffalo NY 14215 Erie 7168985186

Piotrowski, Edward S. Surgical Critical Care Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Rothstein, David H. Surgical Critical Care Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Rothstein, David H. Surgical Critical Care Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Savo, Anthony M. Surgical Critical Care Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787874

Savo, Anthony M. Surgical Critical Care Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168787000

Shin, Kyu H. Therapeutic Radiology CCS Oncology PC 3633 Commerce Pl Hamburg NY 14075 Erie 7166499950

Page 158 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Shin, Kyu H. Therapeutic Radiology CCS Oncology PC 45 Spindrift Buffalo NY 14221 Erie 7168109631

Shin, Kyu H. Therapeutic Radiology CCS Oncology PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Shin, Kyu H. Therapeutic Radiology Cancer Care Radiology Systems PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7168710181

Adkins, Mark S. Thoracic Cadiovascular Srg Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Adkins, Mark S. Thoracic Cadiovascular Srg Mercy Hospital 515 Abbott Rd Rm 101 Buffalo NY 14220 Erie 7169239650

Aldridge, Janerio D. Thoracic Cadiovascular Srg General Physician SUB II PLLC 100 High St C365A Buffalo NY 14203 Erie 7168593392

Ashraf, Mohammad H. Thoracic Cadiovascular Srg General Physician SUB II PLLC 100 High St C365A Buffalo NY 14203 Erie 7168593392

Demmy, Todd L. Thoracic Cadiovascular Srg Kaleida Health 100 High St B-8 The Heart and Lung Center Buffalo NY 14203 Erie 7168597280

Dexter, Elisabeth U. Thoracic Cadiovascular Srg Kaleida Health 100 High St Ste D 8 Buffalo NY 14203 Erie 7168597280

Dexter, Elisabeth U. Thoracic Cadiovascular Srg Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Downing, Stephen W. Thoracic Cadiovascular Srg Mercy Hospital 515 Abbott Rd Rm 101 Buffalo NY 14220 Erie 7169239650

Grosner, Gary Thoracic Cadiovascular Srg General Physician SUB II PLLC 100 High St C365A Buffalo NY 14203 Erie 7168593392

Hennon, Mark W. Thoracic Cadiovascular Srg Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Huang, Miriam Thoracic Cadiovascular Srg Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Jennings, Lujean Thoracic Cadiovascular Srg Niagara Medicine PC 2157 Main St Buffalo NY 14220 Erie 7168621965

Jennings, Lujean Thoracic Cadiovascular Srg Niagara Medicine PC 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Jennings, Lujean Thoracic Cadiovascular Srg Niagara Medicine PC 100 High St Buffalo NY 14203 Erie 7168595600

Jennings, Lujean Thoracic Cadiovascular Srg Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Jennings, Lujean Thoracic Cadiovascular Srg Niagara Medicine PC 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Jennings, Lujean Thoracic Cadiovascular Srg Niagara Medicine PC 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Lico, Serrie C. Thoracic Cadiovascular Srg Lico, Serrie C. 565 Abbott Rd Buffalo NY 14220 Erie 7168217714

Lico, Serrie C. Thoracic Cadiovascular Srg Lico, Serrie C. 515 Abbott Rd Ste 101 Buffalo NY 14220 Erie 7168217714

Picone, Anthony L. Thoracic Cadiovascular Srg Cardiovascular & Thoracic Surgery of WNY 462 Grider St Buffalo NY 14215 Erie 7168985858

Picone, Anthony L. Thoracic Cadiovascular Srg Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Takita, Hiroshi Thoracic Cadiovascular Srg General Physician SUB II PLLC 100 High St Ste C3 Buffalo NY 14203 Erie 7162202342

Vonfricken, Kurt Thoracic Cadiovascular Srg Buffalo Cardiac Surgical Associates Llp 100 High St Buffalo NY 14203 Erie 7168592247

Aldridge, Janerio D. Thoracic Surgery Buffalo Thoracic Surgical Associates Pc 100 High St Buffalo NY 14203 Erie 7168597600

Ashraf, Mohammad H. Thoracic Surgery Buffalo Thoracic Surgical Associates Pc 100 High St Buffalo NY 14203 Erie 7168597600

Bell Thomson, John Thoracic Surgery SURGXL Cardiothoracic Services 22 Cazenovia St Buffalo NY 14220 Erie 7168281410

Demmy, Todd L. Thoracic Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical 6934 Williams Rd Ste 300 Buffalo NY 14203 Erie 7168453500

Demmy, Todd L. Thoracic Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Dexter, Elisabeth U. Thoracic Surgery Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Grosner, Gary Thoracic Surgery Buffalo Cardiac Surgical Associates Llp C3 100 High St Buffalo NY 14203 Erie 7168593392

Hennon, Mark W. Thoracic Surgery VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Jajkowski, Mark R. Thoracic Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983700

Jennings, Lujean Thoracic Surgery Buffalo Thoracic Surgical Associates Pc 100 High St Buffalo NY 14203 Erie 7168597600

Levinsky, Leon Thoracic Surgery Advanced Cardiac Surgical Assoc Pllc C3 100 High St Buffalo NY 14203 Erie 7168593392

Levinsky, Leon Thoracic Surgery VascuFlo, Inc 2447 Sheridan Dr Tonawanda NY 14150 Erie 7166812968

Levinsky, Leon Thoracic Surgery Kaleida Health 100 High St Buffalo NY 14203 Erie 7168593392

Levinsky, Leon Thoracic Surgery VascuFlo, Inc 2470 Walden Ave Ste 300 Cheektowaga NY 14225 Erie 7166812968

Levinsky, Leon Thoracic Surgery Kaleida Health 100 High St B 8 Buffalo NY 14203 Erie 7168597280

Picone, Anthony L. Thoracic Surgery Buffalo Cardiac Surgical Associates Llp 1540 Maple Rd Williamsville NY 14221 Erie 7168592247

Picone, Anthony L. Thoracic Surgery Buffalo Cardiac Surgical Associates Llp 3 Gates Cir Buffalo NY 14209 Erie 7168592247

Picone, Anthony L. Thoracic Surgery Buffalo Cardiac Surgical Associates Llp 100 High St C368 Buffalo NY 14203 Erie 7168592243

Takita, Hiroshi Thoracic Surgery Buffalo Thoracic Surgical Associates Pc 100 High St Buffalo NY 14203 Erie 7168597600

Lagaly, William J. Undersea & Hyperbaric Med Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Caritas Bldg Ste 120 Cheektowaga NY 14225 Erie 7168912570

Lagaly, William J. Undersea & Hyperbaric Med Mercy Hospital 3669 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7166620500

Lagaly, William J. Undersea & Hyperbaric Med Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Lagaly, William J. Undersea & Hyperbaric Med Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Lagaly, William J. Undersea & Hyperbaric Med Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Morgan, Monica L. Undersea & Hyperbaric Med Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Caritas Bldg Ste 120 Cheektowaga NY 14225 Erie 7168912570

Morgan, Monica L. Undersea & Hyperbaric Med Mercy Hospital 3669 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7168282330

Ruotsi, Lee C. Undersea & Hyperbaric Med Kenmore Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Ruotsi, Lee C. Undersea & Hyperbaric Med FDR Medical Services PC 1540 Maple Rd Williamsville NY 14221 Erie 7165683600

Ruotsi, Lee C. Undersea & Hyperbaric Med Mercy Hospital 3669 Southwestern Blvd Ste 100 Orchard Park NY 14127 Erie 7168282330

Ruotsi, Lee C. Undersea & Hyperbaric Med Kenmore Mercy Hospital 2875 Union Rd Ste 3550 Cheektowaga NY 14227 Erie 7166013600

Ruotsi, Lee C. Undersea & Hyperbaric Med Sisters of Charity Hospital : St Joseph Campus 2625 Harlem Rd Caritas Bldg Ste 120 Buffalo NY 14225 Erie 7168912570

Ruotsi, Lee C. Undersea & Hyperbaric Med Riverwood Health Care 2850 Grand Island Blvd Grand Island NY 14072 Erie 7167735900

Ruotsi, Lee C. Undersea & Hyperbaric Med Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7162622400

Ruotsi, Lee C. Undersea & Hyperbaric Med FDR Medical Services PC 2850 Grand Island Blvd Grand Island NY 14072 Erie 7167735900

Brendze, Suzanne Urgent Care Ctr - Professional Excel Medical Care PC dba Med Express 4154 McKinley Pkwy Ste 275 Buffalo NY 14217 Erie 7162021462

Mure, Joseph V. Urgent Care Ctr - Professional Excel Medical Care PC dba Med Express 4154 McKinley Pkwy Ste 275 Blasdell NY 14219 Erie 7162021462

Pless, Naomi A. Urgent Care Ctr - Professional Excel Medical Care PC dba Med Express 4154 McKinley Pkwy Ste 275 Buffalo NY 14219 Erie 7162021462

Zionts, Michael E. Urgent Care Ctr - Professional Excel Medical Care PC dba Med Express 4154 McKinley Pkwy Ste 275 Buffalo NY 14219 Erie 7162021462

Aliotta, Philip J. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Buffalo NY 14225 Erie 7168445000

Aliotta, Philip J. Urology Western New York Urology Associates LLC 224 E Main St Springville NY 14141 Erie 7168445000

Page 159 of 162

Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Barlog, Kevin J. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Barlog, Kevin J. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Barlog, Kevin J. Urology Western New York Urology Associates LLC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7168963815

Baumann, Louis R. Urology Western New York Urology Associates LLC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166483415

Baumann, Louis R. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Burkhard, Valerie L. Urology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301050

Burkhard, Valerie L. Urology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301050

Burkhard, Valerie L. Urology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301050

Chazen, Mark D. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Chevli, K Kent Urology Kaleida Health 100 High St Ste D3 Buffalo NY 14203 Erie 7138592524

Chevli, K Kent Urology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Chevli, K Kent Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Danforth, Teresa L. Urology University Urology Inc 100 Hight St C 3 Outpatient Surgical Ste Buffalo NY 14203 Erie 7168985008

Danforth, Teresa L. Urology University Urology Inc Elm and Carlton Sts Buffalo NY 14263 Erie 7168425600

Danforth, Teresa L. Urology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983333

Danforth, Teresa L. Urology University Urology Inc 462 Grider St Ste 119 Buffalo NY 14215 Erie 7168985008

Danforth, Teresa L. Urology University Urology Inc 3045 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7162601593

Danforth, Teresa L. Urology Kaleida Health 100 High St D 3 Specialty Clinic Buffalo NY 14203 Erie 7168592524

Danforth, Teresa L. Urology University Urology Inc 100 High St Ste B-280 Buffalo NY 14203 Erie 7168592212

Danforth, Teresa L. Urology University Urology Inc 2816 Pleasant Ave Lake View NY 14085 Erie 7166465500

Deberry III, John L. Urology John L DeBerry III MD 1275 Delaware Ave Buffalo NY 14209 Erie 7168819077

Doerr, Mark J. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Fugitt, Robert G. Urology Robert G Fugitt Md & David B Lillie Md 3800 Delaware Ave Buffalo NY 14217 Erie 7168733828

Gilbert, Richard N. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Gona, Chandrashaker R. Urology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7168349200

Greco, Joseph M. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445600

Greco, Joseph M. Urology Western New York Urology Associates LLC 3095 Harlem Rd Cheektowaga NY 14225 Erie 7166319600

Greenfield, Saul P. Urology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781260

Greenfield, Saul P. Urology Pediatric Urology of Western New York PC 240 Redtail Ln Ste 5 and 6 Orchard Park NY 14127 Erie 7168787393

Greenfield, Saul P. Urology Pediatric Urology of Western New York PC 219 Bryant St Buffalo NY 14222 Erie 7168787393

Greenfield, Saul P. Urology Pediatric Urology of Western New York PC 3580 Sheridan Dr Amherst NY 14226 Erie 7168787393

Griswold, John J. Urology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301050

Griswold, John J. Urology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578660

Guru, Khurshid A. Urology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Hanzly, Michael I. Urology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Houjaij, Ali Urology VA Western NY Health Med Ctr 3495 Bailey Ave Buffalo NY 14215 Erie 7172776565

Jung, Ichabod S. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Kauffman, Eric C. Urology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Kopp, Christopher F. Urology Western New York Urology Associates LLC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166772273

Kopp, Christopher F. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Lillie, David B. Urology Robert G Fugitt Md & David B Lillie Md 3800 Delaware Ave Ste 104 Kenmore NY 14217 Erie 7168733828

Mohler, James L. Urology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton St Buffalo NY 14263 Erie 7168452300

Perfetto, Carlo M. Urology Western New York Urology Associates LLC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166483415

Perfetto, Carlo M. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Phillips, Emilia Urology Phillips, Emilia 3140 Sheridan Dr Ste 219 Buffalo NY 14226 Erie 7168345517

Pinski, John V. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Pinski, John V. Urology Western New York Urology Associates LLC 224 E Main St Springville NY 14141 Erie 7168445000

Pranikoff, Kevin Urology University Urology Inc 100 High St C 3 Outpatient Surgical Ste Buffalo NY 14203 Erie 7168985008

Pranikoff, Kevin Urology University Urology Inc 462 Grider St Ste 119 1st Fl Buffalo NY 14215 Erie 7168985008

Pranikoff, Kevin Urology Kaleida Health 100 High St D3 Specialty Clinic Buffalo NY 14203 Erie 7168592524

Pranikoff, Kevin Urology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Pranikoff, Kevin Urology University Urology Inc 3045 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7162601593

Pranikoff, Kevin Urology University Urology Inc 2816 Pleasant Ave Lake View NY 14085 Erie 7166465500

Pranikoff, Kevin Urology Pranikoff, Kevin 462 Grider St Ste 119 Buffalo NY 14215 Erie 7168985008

Rambarran, Brian D. Urology Kaleida Health 100 High St Ste D3 Buffalo NY 14203 Erie 7168592524

Rambarran, Brian D. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Ricottone, Anthony R. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Roehmholdt, John M. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Rutkowski, John M. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Schwaab, Thomas Urology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Seereiter Jr, Phillip J. Urology Western New York Urology Associates LLC 7060 Erie Rd Ste 400 Derby NY 14047 Erie 7166772273

Seereiter Jr, Phillip J. Urology Western New York Urology Associates LLC 3040 Amsdell Rd Hamburg NY 14075 Erie 7166483415

Seereiter Jr, Phillip J. Urology Western New York Urology Associates LLC 500 Sterling Dr Orchard Park NY 14127 Erie 7166772273

Skomra, Christopher J. Urology Western New York Urology Associates LLC 3095 Harlem Rd Cheektowaga NY 14224 Erie 7168963815

Skomra, Christopher J. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Sufrin, Gerald Urology Sufrin, Gerald 100 High St Ste B201 Buffalo NY 14203 Erie 7168592212

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Sufrin, Gerald Urology Kaleida Health 100 High St D3 Buffalo NY 14203 Erie 7168592524

Sufrin, Gerald Urology University Urology Inc 100 High St Buffalo NY 14203 Erie 7168985008

Sufrin, Gerald Urology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Sufrin, Gerald Urology University Urology Inc 77 Goodell Ave Third Fl Ste 320 Buffalo NY 14203 Erie 7168167208

Sufrin, Gerald Urology University Urology Inc 462 Grider St First Fl Buffalo NY 14215 Erie 7168985008

Swiantek, Philip A. Urology Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7166301050

Swiantek, Philip A. Urology Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301050

Swiantek, Philip A. Urology Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301050

Swiantek, Philip A. Urology Buffalo Medical Group 495 International Dr Buffalo NY 14221 Erie 7166301050

Tisdale, Britton E. Urology University Urology Inc 100 High St C 3 Outpatient Surgical Ste Buffalo NY 14203 Erie 7168985008

Tisdale, Britton E. Urology University Urology Inc 2816 Pleasant Ave Lake View NY 14085 Erie 7166465500

Tisdale, Britton E. Urology University Urology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Tisdale, Britton E. Urology University Urology Inc 462 Grider St Ste 119 1st Fl Buffalo NY 14215 Erie 7168985008

Tisdale, Britton E. Urology University Urology Inc 3045 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7162601593

Tisdale, Britton E. Urology Kaleida Health 100 High St D3 BGH Urology Clinic Buffalo NY 14203 Erie 7168592524

Tisdale, Britton E. Urology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983333

Tisdale, Britton E. Urology University Urology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7162428327

Turecki, James A. Urology Kaleida Health 100 High St D3 Buffalo NY 14203 Erie 7168592524

Turecki, James A. Urology University Urology Inc 462 Grider St 1st Fl Buffalo NY 14215 Erie 7168985008

Turecki, James A. Urology University Urology Inc 100 High St C 3 Outpatient Surgical Ste Buffalo NY 14203 Erie 7168985008

Turecki, James A. Urology University Urology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Turecki, James A. Urology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983948

Turecki, James A. Urology University Urology Inc 3045 Southwestern Blvd Ste 108 Orchard Park NY 14127 Erie 7162601593

Turecki, James A. Urology University Urology Inc 1540 Maple Rd Williamsville NY 14221 Erie 7162428327

Turecki, James A. Urology University Urology Inc 462 Grider St Ste 119 Buffalo NY 14215 Erie 7168985008

Turecki, James A. Urology University Urology Inc 2816 Pleasant Ave Lake View NY 14085 Erie 7166465500

Underwood, Willie Urology Roswell Park Cancer Institute Corp Dba Rpci Clinical Elm and Carlton Sts Buffalo NY 14263 Erie 7168452300

Wagle, Datta G. Urology Western New York Urology Associates LLC 3085 Harlem Rd Ste 200 Cheektowaga NY 14225 Erie 7168445000

Williot, Pierre E. Urology Pediatric Urology of Western New York PC 3580 Sheridan Dr Eggertsville NY 14226 Erie 7168787393

Williot, Pierre E. Urology Pediatric Urology of Western New York PC 219 Bryant St Buffalo NY 14222 Erie 7168787393

Williot, Pierre E. Urology Kaleida Health 219 Bryant St Buffalo NY 14222 Erie 7168781260

Williot, Pierre E. Urology Pediatric Urology of Western New York PC 240 Redtail Ln Ste 5 and 6 Orchard Park NY 14127 Erie 7168787393

Arbabzadeh, Massoud Vascular & Interv Radio Massoud Arbabzadeh MD PC 564 Niagara St Buffalo NY 14201 Erie 5165474739

Arbabzadeh, Massoud Vascular & Interv Radio Massoud Arbabzadeh MD PC 2809 Wehrle Dr Ste 13 Buffalo NY 14211 Erie 7165361905

Brown, Mark G. Vascular & Interv Radio Foundation Radiology Group PC 222 E Main St Springville NY 14141 Erie 4122232272

Fogel, Jonathan T. Vascular & Interv Radio Vascular - Interventional Associates Pc 100 High St Ste B252 Buffalo NY 14203 Erie 7168521977

Fogel, Jonathan T. Vascular & Interv Radio Vascular - Interventional Associates Pc 27 Franklin St Springville NY 14141 Erie 7168521977

Fogel, Jonathan T. Vascular & Interv Radio Vascular - Interventional Associates Pc 4600 Main St Snyder NY 14226 Erie 7168521977

Fogel, Jonathan T. Vascular & Interv Radio General Physician PC 210 E Main St Springville NY 14141 Erie 7165928151

Iqbal, Azher Vascular & Interv Radio General Physician PC 210 E Main St Springville NY 14141 Erie 7162130025

Iqbal, Azher Vascular & Interv Radio Vascular - Interventional Associates Pc 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168521977

Iqbal, Azher Vascular & Interv Radio WNY PETCT LLC 700 Michigan Ave Buffalo NY 14203 Erie 7168552866

Iqbal, Azher Vascular & Interv Radio Vascular - Interventional Associates Pc 27 Franklin St Springville NY 14141 Erie 7168521977

Iqbal, Azher Vascular & Interv Radio Vascular - Interventional Associates Pc 4600 Main St Snyder NY 14226 Erie 7168520197

Iqbal, Azher Vascular & Interv Radio Vascular - Interventional Associates Pc 100 High St Buffalo NY 14203 Erie 7168521977

Avino, Lorianne E. Vascular Neurology Lorianne E Pereira DO PC 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166083525

Avino, Lorianne E. Vascular Neurology Mercy Hospital 2605 Harlem Rd Buffalo NY 14225 Erie 7168912400

Avino, Lorianne E. Vascular Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Avino, Lorianne E. Vascular Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Avino, Lorianne E. Vascular Neurology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7168621000

Avino, Lorianne E. Vascular Neurology Kenmore Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Avino, Lorianne E. Vascular Neurology Avino, David 3671 Southwestern Blvd Ste 107 Orchard Park NY 14127 Erie 7166672064

Avino, Lorianne E. Vascular Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7162622400

Avino, Lorianne E. Vascular Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Avino, Lorianne E. Vascular Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Avino, Lorianne E. Vascular Neurology Mercy Hospital 515 Abbott Rd Ste 310 Buffalo NY 14220 Erie 7168282300

Avino, Lorianne E. Vascular Neurology Mercy Hospital 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Avino, Lorianne E. Vascular Neurology Mercy Hospital 2157 Main St Buffalo NY 14214 Erie 7168622000

Dofitas, Steve B. Vascular Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Dofitas, Steve B. Vascular Neurology Dent Neurologic Group LLP 7060 Erie Rd Rte 5 Ste 500 Derby NY 14047 Erie 7162502000

Dofitas, Steve B. Vascular Neurology Dent Neurologic Group LLP 3980 Sheridan Dr Ste 200 Amherst NY 14226 Erie 7162502000

Ferguson, Richard E. Vascular Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Kandel, Amit Vascular Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983638

Kandel, Amit Vascular Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168595600

Kandel, Amit Vascular Neurology Kaleida Health 100 High St Buffalo NY 14203 Erie 7168595600

Kass-Hout, Omar Vascular Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168283123

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Univera Preferred Gold Provider Tier 1 Network - Effective Jan. 1, 2015Provider Name Provider Specialty Description Provider Group Name Address Line 1 Address Line 2 Address City Provider Address State Code Provider Address Zip Code Address County Provider Address Phone Number

Kass-Hout, Omar Vascular Neurology Mercy Hospital 2950 Elmwood Ave Kenmore NY 14217 Erie 7164476100

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 3 Gates Cir Buffalo NY 14209 Erie 7168875410

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 219 Bryant St Buffalo NY 14222 Erie 7168787848

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 462 Grider St Buffalo NY 14215 Erie 7168984905

Samie, Mohammad R. Vascular Neurology Samie, M Reza 1616 Kensington St Buffalo NY 14215 Erie 7168283400

Samie, Mohammad R. Vascular Neurology Samie, M Reza 515 Abbott Rd Ste 400 Buffalo NY 14220 Erie 7168283400

Samie, Mohammad R. Vascular Neurology Sisters of Charity Hospital : St Joseph Campus 2605 Harlem Rd Buffalo NY 14225 Erie 7162622400

Samie, Mohammad R. Vascular Neurology Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Samie, Mohammad R. Vascular Neurology Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 1540 Maple Rd Buffalo NY 14221 Erie 7165683600

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 4955 N Bailey Ave Amherst NY 14226 Erie 7168320643

Samie, Mohammad R. Vascular Neurology Sisters of Charity Hospital : St Joseph Campus 2157 Main St Buffalo NY 14214 Erie 7166344798

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 100 High St Buffalo NY 14203 Erie 7168597511

Samie, Mohammad R. Vascular Neurology Univ Neurology Inc 445 Tremont St Tonawanda NY 14150 Erie 7166944500

Anain Sr, Joseph M. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 2121 Main St Ste 316 Buffalo NY 14214 Erie 7168372400

Anain Sr, Joseph M. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 4949 Harlem Rd Ste 302 Amherst NY 14228 Erie 7168372400

Anain, Paul M. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 4949 Harlem Rd Ste 302 Amherst NY 14226 Erie 7168372400

Anain, Paul M. Vascular Surgery Buffalo Medical Group 295 Essjay Rd Williamsville NY 14221 Erie 7166301098

Anain, Paul M. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 2121 Main St Ste 316 Buffalo NY 14214 Erie 7168372400

Blessios, George A. Vascular Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168985240

Blessios, George A. Vascular Surgery Mercy Hospital 565 Abbott Rd Buffalo NY 14220 Erie 7168267000

Blessios, George A. Vascular Surgery George A Blessios 515 Abbott Rd Ste 310 Buffalo NY 14220 Erie 7168222400

Blochle, Raphael Vascular Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Blochle, Raphael Vascular Surgery University at Buffalo Surgeons Inc 462 Grider St Dept of Surgery Buffalo NY 14203 Erie 7168985186

Blochle, Raphael Vascular Surgery University at Buffalo Surgeons Inc 1150 Youngs Rd Ste 108 Williamsville NY 14221 Erie 7162040381

Cherr, Gregory S. Vascular Surgery University at Buffalo Surgeons Inc 100 High St Dept of Surgery Buffalo NY 14203 Erie 7168592810

Curl, G Richard Vascular Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 4600 Main St Ste 100 Amherst NY 14226 Erie 7168593301

Curl, G Richard Vascular Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 100 High St Ste A2 Buffalo NY 14203 Erie 7166923302

Curl, G Richard Vascular Surgery Buffalo Medical Group Dept 316 PO Box 8000 Buffalo NY 14267 Erie 7166302513

Dominguez, Ivan Vascular Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 4600 Main St Amherst NY 142264500 Erie 7168593301

Dominguez, Ivan Vascular Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 100 High St Ste A2 Buffalo NY 14203 Erie 7168593301

Dominguez, Ivan Vascular Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168983000

Dosluoglu, Hasan H. Vascular Surgery University at Buffalo Surgeons Inc 100 High St Dept Of Surg Buffalo NY 14203 Erie 7168593349

Dosluoglu, Hasan H. Vascular Surgery University at Buffalo Surgeons Inc 462 Grider St Dk Miller Bldg Buffalo NY 14215 Erie 7168985186

Dosluoglu, Hasan H. Vascular Surgery University at Buffalo Surgeons Inc 3 Gates Cir Dept Of Surg Buffalo NY 14209 Erie 7168874223

Dryjski, Maciej L. Vascular Surgery University at Buffalo Surgeons Inc 100 High St Bldg B 7th Fl Buffalo NY 14203 Erie 7168592810

Dryjski, Maciej L. Vascular Surgery University at Buffalo Surgeons Inc 100 High St Dept of Surgery Buffalo NY 14203 Erie 7168594225

Harris, Linda M. Vascular Surgery University at Buffalo Surgeons Inc 462 Grider St Ecmc Miller Bldg Buffalo NY 14215 Erie 7168985103

Harris, Linda M. Vascular Surgery University at Buffalo Surgeons Inc 100 High St Bldg B 7th Fl Buffalo NY 14203 Erie 7168592810

Harris, Linda M. Vascular Surgery University at Buffalo Surgeons Inc 100 High St 7th FL. Buffalo NY 14203 Erie 7168594225

Harris, Linda M. Vascular Surgery University at Buffalo Surgeons Inc 1150 Youngs Rd Ste 108 Buffalo NY 14221 Erie 7162040381

Kassavin, Daniel S. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 4949 Harlem Rd Ste 302 Amherst NY 14228 Erie 7168372400

Kassavin, Daniel S. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 2121 Main St Ste 316 Buffalo NY 14214 Erie 7168372400

Leary III, Daniel A. Vascular Surgery Alvarez MD and Leary MD PC 3030 Orchard Park Rd Ste B Buffalo NY 14224 Erie 7166718393

Leary III, Daniel A. Vascular Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 100 High St Ste A2 Buffalo NY 14203 Erie 7168593301

Leary III, Daniel A. Vascular Surgery Buffalo Endovascular & Vascular Surgical Associates PLL 4600 Main St Ste 100 Amherst NY 14226 Erie 7168593301

Peer, Richard M. Vascular Surgery Buffalo Heart Group LCP 3435 Bailey Ave Buffalo NY 14215 Erie 7168352966

Peer, Richard M. Vascular Surgery Buffalo Medical Group 3900 N Buffalo Rd Orchard Park NY 14127 Erie 7166301000

Peer, Richard M. Vascular Surgery Buffalo Medical Group 85 High St Buffalo NY 14203 Erie 7168578600

Peer, Richard M. Vascular Surgery Buffalo Heart Group LCP 85 High St Buffalo NY 14203 Erie 7168578600

Pell, Michael A. Vascular Surgery Terrace View 462 Grider St Buffalo NY 14215 Erie 7168985240

Pell, Michael A. Vascular Surgery Michael A Pell MD PC 700 Michigan Ave Buffalo NY 14203 Erie 7168403385

Rammohan, Surianarayan Vascular Surgery Surianarayanan Rammohan 100 High St Buffalo NY 14203 Erie 7168595600

Rammohan, Surianarayan Vascular Surgery Surianarayanan Rammohan 2157 Main St Buffalo NY 14214 Erie 7168621000

Rammohan, Surianarayan Vascular Surgery Surianarayanan Rammohan 2949 Elmwood Ave Ste 201 Buffalo NY 14217 Erie 7168770053

Rammohan, Surianarayan Vascular Surgery Surianarayanan Rammohan 2950 Elmwood Ave Buffalo NY 14217 Erie 7164476100

Rammohan, Surianarayan Vascular Surgery Surianarayanan Rammohan 2605 Harlem Rd Cheektowaga NY 14225 Erie 7168912400

Rivero, Mariel Vascular Surgery University at Buffalo Surgeons Inc 100 High St Dept of Surgery 7th Fl Buffalo NY 14203 Erie 7168594225

Swartz, Aimee J. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 2121 Main St Ste 316 Buffalo NY 14214 Erie 7168372400

Swartz, Aimee J. Vascular Surgery Anain and Anain LLP dba Vascular/Endo Ctr of WNY 4949 Harlem Rd Ste 302 Amherst NY 14228 Erie 7168372400

Taheri, Hamed Vascular Surgery Alvarez MD and Leary MD PC 3030 Orchard Park Rd Ste B West Seneca NY 14224 Erie 7166718393

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