MEDICARE: DR. AMY KATHERINE NIERTIT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	57-013862	OH
2	207P00000X	Emergency Medicine Physician	288518	NY

General Provider Information

NPI Number	:	1699944629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY KATHERINE NIERTIT M.D.

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE BOX 655-A
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-1342
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 ELMWOOD AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-1619
Country	:	US
Telephone Number	:	585-275-9555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2008
Last Update Date	:	06/29/2023

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