Individual
AMY LYNN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2816 PLEASANT AVE, LAKE VIEW, NY 14085-9624
(716) 646-5500
Mailing address
837 SUN VALLEY DR, NORTH TONAWANDA, NY 14120-1923
(716) 715-7403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
021394-1
NY
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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