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General NPI Number Information
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NPI Number | 1871379586
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Entity Type | Organization
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Legal Business Name | ROSWELL PARK CANCER INSTITUTE
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 203 PARK CLUB LANE SUITE Z-200
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-845-8936
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Fax |
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Provider Business Mailing Address
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Address Line | ELM AND CARLTON ST
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City | BUFFALO
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State | NY
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Zip | 14263-0001
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Country | US
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Telephone | 716-845-5785
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. CANDACE JOHNSON
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Credential | PHD
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Telephone | 716-845-5772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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