Healthcare Provider Details

I. General information

NPI: 1316829450
Provider Name (Legal Business Name): ASHLEY SANAYIA LAIDLAW PMHNP-BC, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 AUTUMN CREEK LN
EAST AMHERST NY
14051-2920
US

IV. Provider business mailing address

105 AUTUMN CREEK LN
EAST AMHERST NY
14051-2920
US

V. Phone/Fax

Practice location:
  • Phone: 516-444-9388
  • Fax:
Mailing address:
  • Phone: 516-444-9388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number406422
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number735554
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: