Individual
BIANCA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
156 MILLICENT AVE, BUFFALO, NY 14215-2818
(716) 495-5573
Mailing address
156 MILLICENT AVE, BUFFALO, NY 14215-2818
(716) 495-5573
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
984908169
NY
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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