Provider Demographics
NPI:1104000868
Name:NASH, AMY B (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:NASH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 EARHART DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7809
Mailing Address - Country:US
Mailing Address - Phone:716-946-5139
Mailing Address - Fax:
Practice Address - Street 1:45 EARHART DR
Practice Address - Street 2:SUITE 110
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7809
Practice Address - Country:US
Practice Address - Phone:716-946-5139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY050760OtherRPH LICENSE