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General NPI Number Information
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NPI Number | 1083189336
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Entity Type | Individual
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Provider Name | EMILY ROSS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 462 GRIDER ST
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City | BUFFALO
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State | NY
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Zip | 14215-3098
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Country | US
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Telephone | 716-898-3108
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Fax | 716-898-3108
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Provider Business Mailing Address
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Address Line | 3836 HIGHLAND AVE
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City | SKANEATELES
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State | NY
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Zip | 13152-9355
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Country | US
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Telephone | 315-569-4972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402518
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License Number State | NY
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