Healthcare Provider Details

I. General information

NPI: 1396834818
Provider Name (Legal Business Name): DARLENE J. ROSS RN, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8899 MAIN ST
WILLIAMSVILLE NY
14221-7628
US

IV. Provider business mailing address

PO BOX 162
EAST PEMBROKE NY
14056-0162
US

V. Phone/Fax

Practice location:
  • Phone: 716-560-1319
  • Fax: 585-762-9924
Mailing address:
  • Phone: 716-560-1319
  • Fax: 585-762-9924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number345911
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number016978
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: