Healthcare Provider Details

I. General information

NPI: 1902873839
Provider Name (Legal Business Name): JEFFREY BRUCE ROCKOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 BRYANT STREET
BUFFALO NY
14222-2006
US

IV. Provider business mailing address

4511 HARLEM ROAD SUITE 202
AMHERST NY
14226-3822
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-8980
  • Fax: 716-362-0340
Mailing address:
  • Phone: 716-839-6720
  • Fax: 716-839-6740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number170657
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number170657
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: