Healthcare Provider Details

I. General information

NPI: 1467528802
Provider Name (Legal Business Name): WILLIAM ROFFMAN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SPENCERPORT RD
ROCHESTER NY
14606-5206
US

IV. Provider business mailing address

44 LOCH REVAN HTS
ROCHESTER NY
14617-3302
US

V. Phone/Fax

Practice location:
  • Phone: 585-247-3473
  • Fax:
Mailing address:
  • Phone: 585-338-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number027345
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: