Provider Demographics
NPI:1417130535
Name:BEYRLE, AMY C (RPA-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:BEYRLE
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:CLOUTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:601 ELMWOOD AVE BOX 670
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-467-1643
Mailing Address - Fax:
Practice Address - Street 1:2180 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2665
Practice Address - Country:US
Practice Address - Phone:585-467-1643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12324363A00000X
NY012324-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant