Healthcare Provider Details

I. General information

NPI: 1356043434
Provider Name (Legal Business Name): AIMEE BRADY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 E ROBINSON RD STE 207
WEST AMHERST NY
14228-2044
US

IV. Provider business mailing address

1150 YOUNGS RD STE 104
WILLIAMSVILLE NY
14221-8096
US

V. Phone/Fax

Practice location:
  • Phone: 716-564-1111
  • Fax: 716-929-0194
Mailing address:
  • Phone: 716-636-7990
  • Fax: 716-636-7992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF311190
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: