Individual
AMY JEANNE BRUECKNER AMEDURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
14 BRISTOL LN, ELLICOTTVILLE, NY 14731
(716) 699-9032
(716) 699-9035
Mailing address
57 WOODLAND LN, PALENVILLE, NY 12463-2525
(518) 542-4643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
233710
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02701077
—
NY
Enumeration date
01/17/2006
Last updated
01/22/2020
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