Healthcare Provider Details

I. General information

NPI: 1649199985
Provider Name (Legal Business Name): PREMIER HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3098
US

IV. Provider business mailing address

51 FRADINE DR
CHEEKTOWAGA NY
14227-3016
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-3225
  • Fax:
Mailing address:
  • Phone: 716-280-9665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KAILEE R ROLSTON
Title or Position: POSTDOCTORAL FELLOW
Credential: PSY.D.
Phone: 716-280-9665