Basic Information
| Provider Information | |||||||||
| NPI: | 1982628517 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PAILY | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 174 PEPPERTREE DRIVE | ||||||||
| Address2: | UNIT 7 | ||||||||
| City: | AMHERST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7167990848 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7 COMMUNITY DR | ||||||||
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| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142252523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165055630 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 08/16/2007 | ||||||||
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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 | 225X00000X | 012461 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 00027081101 | 01 | NY | UNIVERA | OTHER | 9614255 | 01 | NY | INDEPENDENT HEALTH | OTHER |