Provider Demographics
NPI:1033131388
Name:POHLMAN, AMY RENEE (P A)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:RENEE
Last Name:POHLMAN
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 S BENZING RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1705
Mailing Address - Country:US
Mailing Address - Phone:716-662-5357
Mailing Address - Fax:716-662-2774
Practice Address - Street 1:3670 S BENZING RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1705
Practice Address - Country:US
Practice Address - Phone:716-662-5357
Practice Address - Fax:716-662-2774
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0100561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9512750OtherIHA
NY0026512801OtherUNIVERA
NE954152750OtherCOMM BLUE
NYPA0573Medicare ID - Type Unspecified
NE954152750OtherCOMM BLUE