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General NPI Number Information
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NPI Number | 1306025960
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Entity Type | Individual
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Provider Name | AMY L.M. ROBERSON RPA-C
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Gender | Female
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 1522 OLD BURRSTONE RD
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City | UTICA
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State | NY
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Zip | 13502-4804
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Country | US
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Telephone | 315-797-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 2758 ONEIDA ST
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City | SAUQUOIT
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State | NY
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Zip | 13456-3108
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Country | US
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Telephone | 315-323-0866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 012124-1
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License Number State | NY
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