National Provider Identifier

Amanda N Wilson, PA

Amanda N Wilson, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Cheektowaga, NY and a listed phone number of (716) 681-9000.

NPI 1467826776Cheektowaga, NYPhysician Assistant

Profile Overview

NPI
1467826776
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
November 24, 2015
Last Updated
May 02, 2021

Practice Location

  • 3884 Broadway St
  • Cheektowaga, NY 14227-1111

Phone: (716) 681-9000

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1467826776
Entity Type
Individual
Last Name
Wilson
First Name
Amanda
Middle Name
N
Credential
PA
Provider Other Last Name
Smith
Provider Other First Name
Amanda
Provider Other Middle Name
N
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
3884 Broadway St
Mailing City
Cheektowaga
Mailing State
NY
Mailing ZIP Code
14227-1111
Mailing Country
US
Mailing Phone
(716) 681-9000
Mailing Fax
(716) 256-1079
Practice Street Address
3884 Broadway St
Practice City
Cheektowaga
Practice State
NY
Practice ZIP Code
14227-1111
Practice Country
US
Practice Phone
(716) 681-9000
Enumeration Date
November 24, 2015
Last Updated
May 02, 2021
Sex
Female
Sole Proprietor
No
Certification Date
May 02, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
8391586 (NY, Cigna), 8204874 (NY, Mvp)