Provider Demographics
NPI:1871547463
Name:WNEK, AMY LYNN (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:WNEK
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 1:3675 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1732
Mailing Address - Country:US
Mailing Address - Phone:716-972-0279
Mailing Address - Fax:
Practice Address - Street 1:3675 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1732
Practice Address - Country:US
Practice Address - Phone:716-972-0279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225912-1207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000526813003OtherBC/BS OF WNY HMO
NY041450OtherINDEPENDENT HEALTH NY HMO
NY02312783Medicaid
NY00026006603OtherUNIVERA HEALTHCARE NY HMO
NY00026006603OtherUNIVERA HEALTHCARE NY HMO
NY02312783Medicaid
NY000526813003OtherBC/BS OF WNY HMO
NY041450OtherINDEPENDENT HEALTH NY HMO