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General NPI Number Information
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NPI Number | 1366447765
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Entity Type | Individual
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Provider Name | AMY JEANENE MUNRO PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 3884 BROADWAY
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City | CHEEKTOWAGA
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State | NY
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Zip | 14227-1104
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Country | US
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Telephone | 716-981-9000
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Fax | 716-256-1079
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Provider Business Mailing Address
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Address Line | 3884 BROADWAY
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City | CHEEKTOWAGA
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State | NY
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Zip | 14227-1104
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Country | US
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Telephone | 716-681-9000
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Fax | 716-256-1079
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008116-1
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License Number State | NY
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