MEDICARE: ASHLEY HAMM

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	164W00000X	Licensed Practical Nurse	337207	NY

General Provider Information

NPI Number	:	1689213142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY HAMM

Provider Business Mailing Address
First Line	:	640 MCKINLEY PKWY
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14220-1502
Country	:	US
Telephone Number	:	716-479-6890
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 MCKINLEY PKWY
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14220-1502
Country	:	US
Telephone Number	:	716-479-6890
Fax Number	:

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

Provider Enumeration Date	:	01/02/2020
Last Update Date	:	01/02/2020

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Directions to “ ASHLEY HAMM ” Practice Location

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