Provider Demographics
NPI:1679787733
Name:ENSER, AMY ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:ENSER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 UNION RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1400
Mailing Address - Country:US
Mailing Address - Phone:716-656-8600
Mailing Address - Fax:716-656-1560
Practice Address - Street 1:350 GREENHAVEN TER
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-5547
Practice Address - Country:US
Practice Address - Phone:716-213-0772
Practice Address - Fax:716-213-0773
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB4475Medicare PIN