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General NPI Number Information
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NPI Number | 1306191564
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Entity Type | Individual
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Provider Name | MRS. AMY L AUSTIN
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Gender | Female
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 2545 SHERIDAN DR
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City | TONAWANDA
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State | NY
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Zip | 14150-9478
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Country | US
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Telephone | 716-833-4884
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Fax |
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Provider Business Mailing Address
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Address Line | 65 CHELTENHAM DR
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City | BUFFALO
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State | NY
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Zip | 14216-2227
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Country | US
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Telephone | 716-877-3758
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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