MEDICARE: AMY BENZING

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	163W00000X	Registered Nurse	3898151	NY

General Provider Information

NPI Number	:	1417476581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BENZING

Provider Business Mailing Address
First Line	:	531 IVY RD
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-9676
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6855 SOUTHWESTERN BLVD
Second Line	:
City	:	LAKE VIEW
State	:	NY
Zip	:	14085-9642
Country	:	US
Telephone Number	:	716-627-5970
Fax Number	:

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

Provider Enumeration Date	:	09/11/2017
Last Update Date	:	09/11/2017

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Directions to “ AMY BENZING ” Practice Location

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