Healthcare Provider Details

I. General information

NPI: 1053487645
Provider Name (Legal Business Name): AMY SUSAN PATTERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 MONROE AVE
ROCHESTER NY
14620-1662
US

IV. Provider business mailing address

6668 MILESTRIP RD
ORCHARD PARK NY
14127-1610
US

V. Phone/Fax

Practice location:
  • Phone: 716-261-6152
  • Fax:
Mailing address:
  • Phone: 716-662-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number487991-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number487991
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: