Provider Demographics
NPI:1689240145
Name:SAWICKI, AMANDA (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:SAWICKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 N FOREST RD STE 115
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1200
Mailing Address - Country:US
Mailing Address - Phone:716-650-3000
Mailing Address - Fax:
Practice Address - Street 1:1360 N FOREST RD STE 115
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-1200
Practice Address - Country:US
Practice Address - Phone:716-650-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310186363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health