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Individual

AUBREY ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
780 RIDGE RD, LACKAWANNA, NY 14218-1629
(716) 828-9500
Mailing address
325 MILL RD, APT N 55, EAST AURORA, NY 14052-2841
(716) 870-5649

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
107001071
NY
174400000X
Specialist
107311071
NY
174400000X
Specialist
292023091
NY
174400000X
Specialist
306819091
NY
174400000X
Specialist
Primary
306820091
NY

Other

Enumeration date
08/06/2012
Last updated
08/06/2012
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