Healthcare Provider Details

I. General information

NPI: 1235380619
Provider Name (Legal Business Name): AMANDA BUELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 INNSBRUCK DR
CHEEKTOWAGA NY
14227-2735
US

IV. Provider business mailing address

5965 TRANSIT RD
EAST AMHERST NY
14051-2368
US

V. Phone/Fax

Practice location:
  • Phone: 716-668-7069
  • Fax:
Mailing address:
  • Phone: 716-932-1124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209028474
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335714-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: