Provider Demographics
NPI:1497705016
Name:ALBERT, AMY (RPAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-883-6800
Mailing Address - Fax:716-883-6853
Practice Address - Street 1:85 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1149
Practice Address - Country:US
Practice Address - Phone:716-883-6800
Practice Address - Fax:716-883-6853
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY010065363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ21049Medicare UPIN