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General NPI Number Information
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NPI Number | 1548795958
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Entity Type | Individual
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Provider Name | ANDREW P BOOTH
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Gender | Male
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Dates
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Enumeration Date | 04/23/2017
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Last Update Date | 09/12/2019
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE BOX 655 A
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-275-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 3925 SHERIDAN DR STE 100
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City | AMHERST
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State | NY
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Zip | 14226-1738
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Country | US
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Telephone | 716-250-6492
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Fax | 716-250-6522
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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 |
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License Number State |
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