Individual
CAROLYN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3980 SHERIDAN DR, SUITE 200, AMHERST, NY 14226-1727
(716) 250-2000
(716) 636-1365
Mailing address
3980 SHERIDAN DR, SUITE 600, AMHERST, NY 14226-1727
(716) 250-2000
(716) 250-2040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010219
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570048001
BLUE CROSS & BLUE SHIELD
NY
01
—
000570048002
BLUE CROSS & BLUE SHIELD
NY
05
—
02637790
—
NY
01
—
9512749
INDEPENDENT HEALTH
NY
Enumeration date
12/27/2006
Last updated
07/08/2007
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