Provider Demographics
NPI:1528195617
Name:TALLMAN, AMY M (CNP)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:TALLMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:M
Other - Last Name:TALLMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:564 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-1108
Mailing Address - Country:US
Mailing Address - Phone:716-768-7700
Mailing Address - Fax:716-768-7656
Practice Address - Street 1:564 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1108
Practice Address - Country:US
Practice Address - Phone:716-768-7700
Practice Address - Fax:716-768-7656
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4205681363LW0102X
NY420568363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9512299OtherIHA
NY000560653001OtherBLUECROSS AND BLUESHIELD
NYCC9887Medicare ID - Type Unspecified
NY000560653001OtherBLUECROSS AND BLUESHIELD