Basic Information
| Provider Information | |||||||||
| NPI: | 1669637484 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FARMER | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CAMPBELL | ||||||||
| OtherFirstName: | AMY | ||||||||
| OtherMiddleName: | FRANCES | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 40 GEORGE KARL BLVD | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142217183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162181000 | ||||||||
| FaxNumber: | 7162001857 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HIGH ST | ||||||||
| Address2: | SUITE B-4 | ||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142031126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162181000 | ||||||||
| FaxNumber: | 7168597480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2008 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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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 | 012613-1 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 207T00000X | 012613 | NY | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.