Provider Demographics
NPI:1174626170
Name:DAMIANI, AMY L (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:L
Last Name:DAMIANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048
Mailing Address - Country:US
Mailing Address - Phone:716-363-6960
Mailing Address - Fax:716-363-6964
Practice Address - Street 1:36 THOMAS INDIAN SCHOOL DRIVE
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081-1408
Practice Address - Country:US
Practice Address - Phone:716-532-5582
Practice Address - Fax:716-242-6344
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190873207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01417358Medicaid
NY020024504OtherRAILROAD MEDICARE
NYF33574Medicare UPIN
NY37085GMedicare ID - Type Unspecified
NY020024504OtherRAILROAD MEDICARE