Basic Information
| Provider Information | |||||||||
| NPI: | 1316903321 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | EARLY | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ELM AND CARLTON ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142630001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168452300 | ||||||||
| FaxNumber: | 7168453423 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 COLLEGE PKWY | ||||||||
| Address2: | SUITE 290 | ||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142216800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168458711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 07/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 131051 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 161000580 | 01 | NY | NORTH AMERICAN PREFERRED | OTHER | 0021748 | 01 | NY | GHI | OTHER | 00716610 | 05 | NY | MEDICAID | 2700550 | 01 | NY | IHA | OTHER | 000508594003 | 01 | NY | HEALTH NOW | OTHER | 00010049801 | 01 | NY | UNIVERA | OTHER | 110038838 | 01 | NY | RR MEDICARE | OTHER |