Healthcare Provider Details

I. General information

NPI: 1174588024
Provider Name (Legal Business Name): ANDREA E GUNNELLS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANDREA VERRASTRO

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 SHERIDAN DR 6TH FLOOR
AMHERST NY
14226-1727
US

IV. Provider business mailing address

3980 SHERIDAN DRIVE
AMHERST NY
14226-2918
US

V. Phone/Fax

Practice location:
  • Phone: 716-250-2000
  • Fax: 716-250-2040
Mailing address:
  • Phone: 716-565-1234
  • Fax: 716-565-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333551
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: