Provider Demographics
NPI:1508007824
Name:CHAPPELL, AMY F (RPA-C MPAS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:F
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:RPA-C MPAS
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:F
Other - Last Name:KOTARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:ELM AND CARLTON STREETS
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:716-845-2300
Mailing Address - Fax:716-845-2391
Practice Address - Street 1:ELM AND CARLTON STREETS
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-2391
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013131363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000531397005OtherBLUE CROSS BLUE SHIELD WNY
NY02877796Medicaid
NY9515583OtherINDEPENDENT HEALTH
NYP00881023OtherRAILROAD MEDICARE
NYJ400086993Medicare PIN