MEDICARE: HEIDI A CORNELL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	305020	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	305020	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1205063773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI A CORNELL NP

Provider Business Mailing Address
First Line	:	2350 MAPLE RD
Second Line	:	STE 100
City	:	AMHERST
State	:	NY
Zip	:	14221-4080
Country	:	US
Telephone Number	:	716-688-6500
Fax Number	:	716-688-6501

Provider Business Practice Location Address
First Line	:	2350 MAPLE RD
Second Line	:	STE 100
City	:	AMHERST
State	:	NY
Zip	:	14221-4080
Country	:	US
Telephone Number	:	716-688-6500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	03/18/2020

Similar Medicare Providers

1073562716 — JOHN FUDYMA MD
Practice Location Address:

2350 MAPLE RD STE 100
AMHERST, NY
14221-4080

Practice Phone: 716-688-6500
Practice Fax: 716-688-6501

1184936833 — SAMANTHA ANNE OLEWNIK PA-C
Practice Location Address:

2350 MAPLE RD STE 100
AMHERST, NY
14221-4080

Practice Phone: 716-688-6500
Practice Fax: 716-688-6501

1033606736 — BRADLEY CARRIER MD, MS
Practice Location Address:

2350 MAPLE RD
AMHERST, NY
14221-4080

Practice Phone: 716-688-6500
Practice Fax:

1811454960 — MARIELLE REBECCA WIEDE PA
Practice Location Address:

2350 MAPLE RD STE 100
AMHERST, NY
14221-4080

Practice Phone: 716-688-6500
Practice Fax:

1982258422 — LATUS PRIMARY CARE MEDICINE, PLLC DBA LATUS MEDICAL CARE
Practice Location Address:

2350 MAPLE RD STE 100
AMHERST, NY
14221-4080

Practice Phone: 716-688-6500
Practice Fax: 716-688-6501

1013640564 — LEAH VANDENBOSCH PA-C
Practice Location Address:

2350 MAPLE RD STE 100
WILLIAMSVILLE, NY
14221-4080

Practice Phone: 716-839-8000
Practice Fax:

Directions to “ HEIDI A CORNELL NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.