Provider Demographics
NPI:1790081388
Name:BLOCHBERGER, AMY SUE (LPN)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUE
Last Name:BLOCHBERGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SLOAN
Mailing Address - State:NY
Mailing Address - Zip Code:14212
Mailing Address - Country:US
Mailing Address - Phone:716-908-9565
Mailing Address - Fax:716-894-4429
Practice Address - Street 1:83 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:SLOAN
Practice Address - State:NY
Practice Address - Zip Code:14212-2345
Practice Address - Country:US
Practice Address - Phone:716-908-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY677689-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse