Healthcare Provider Details

I. General information

NPI: 1902958721
Provider Name (Legal Business Name): LYNN A. AMARANTE, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5144 SHERIDAN DR
WILLIAMSVILLE NY
14221-4648
US

IV. Provider business mailing address

5144 SHERIDAN DR
WILLIAMSVILLE NY
14221-4648
US

V. Phone/Fax

Practice location:
  • Phone: 716-632-2311
  • Fax: 716-632-3140
Mailing address:
  • Phone: 716-632-2311
  • Fax: 716-632-3140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number177830-1
License Number StateNY

VIII. Authorized Official

Name: DR. LYNN AUDREY AMARANTE
Title or Position: OWNER
Credential: MD
Phone: 716-632-2311