Individual
CHANELL M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 SENECA ST, BUFFALO, NY 14204-1963
(716) 275-2623
Mailing address
500 SENECA ST, BUFFALO, NY 14204-1963
(716) 275-2623
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
341211-01
NY
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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