Basic Information
Provider Information
NPI: 1275101693
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNAPP
FirstName: LINDSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 151 CALLODINE AVE
Address2:  
City: AMHERST
State: NY
PostalCode: 142263127
CountryCode: US
TelephoneNumber: 5852171383
FaxNumber:  
Practice Location
Address1: 3805 LOCKPORT OLCOTT RD
Address2:  
City: LOCKPORT
State: NY
PostalCode: 140941128
CountryCode: US
TelephoneNumber: 7164394248
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2021
LastUpdateDate: 06/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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