Healthcare Provider Details

I. General information

NPI: 1316565450
Provider Name (Legal Business Name): ROSANNE MARIE RYAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSANNE CARBONE

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 STERLING DR STE 300
ORCHARD PARK NY
14127-1577
US

IV. Provider business mailing address

55 DODGE RD
GETZVILLE NY
14068-1205
US

V. Phone/Fax

Practice location:
  • Phone: 716-662-6802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102975
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: