Provider Demographics
NPI:1023374311
Name:MURDOCK, AMY LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5300 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1903
Mailing Address - Country:US
Mailing Address - Phone:716-298-4800
Mailing Address - Fax:716-297-3302
Practice Address - Street 1:1 COLOMBA DR STE 5
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14305-1275
Practice Address - Country:US
Practice Address - Phone:716-298-2249
Practice Address - Fax:716-297-3302
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015204-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist