Basic Information
| Provider Information | |||||||||
| NPI: | 1619212925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STORY | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | PHYSICIAN ASSISTANT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5225 SHERIDAN DR | ||||||||
| Address2: | RIGHT UNIT | ||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142213573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166262644 | ||||||||
| FaxNumber: | 7166262660 | ||||||||
| Practice Location | |||||||||
| Address1: | 4535 SOUTHWESTERN BLVD | ||||||||
| Address2: | SUITE 801 AND 802 | ||||||||
| City: | HAMBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140751860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166466075 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2012 | ||||||||
| LastUpdateDate: | 01/18/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.