Individual
AMY JEANENE MUNRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3884 BROADWAY, CHEEKTOWAGA, NY 14227-1104
(716) 981-9000
(716) 256-1079
Mailing address
3884 BROADWAY, CHEEKTOWAGA, NY 14227-1104
(716) 681-9000
(716) 256-1079
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008116-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02345504
—
NY
01
—
0945293
CIGN
NY
01
—
1039551
WELLCARE
NY
01
—
113653686118
TODAY'S OPTION
NY
01
—
9776524
AETNA
NY
01
—
PC139377
MVP
NY
Enumeration date
06/14/2005
Last updated
10/05/2017
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