Healthcare Provider Details

I. General information

NPI: 1497679070
Provider Name (Legal Business Name): AMIE E LIBBY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 MAIN ST
SILVER CREEK NY
14136-1447
US

IV. Provider business mailing address

PO BOX 164
SILVER CREEK NY
14136-0164
US

V. Phone/Fax

Practice location:
  • Phone: 716-969-7770
  • Fax: 716-788-2023
Mailing address:
  • Phone: 716-969-7770
  • Fax: 716-788-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: