1669637484 NPI number — MRS. AMY FRANCES FARMER PA-C

Table of content: MRS. AMY FRANCES FARMER PA-C (NPI 1669637484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669637484 NPI number — MRS. AMY FRANCES FARMER PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FARMER
Provider First Name:
AMY
Provider Middle Name:
FRANCES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAMPBELL
Provider Other First Name:
AMY
Provider Other Middle Name:
FRANCES
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669637484
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 GEORGE KARL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-7183
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-218-1000
Provider Business Mailing Address Fax Number:
716-200-1857

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 HIGH ST
Provider Second Line Business Practice Location Address:
SUITE B-4
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14203-1126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-218-1000
Provider Business Practice Location Address Fax Number:
716-859-7480
Provider Enumeration Date:
07/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  012613-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X , with the licence number: 012613 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)