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Individual

SEAN M. ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1300 ELMWOOD AVE # 108, BUFFALO, NY 14222-1004
(716) 878-5328
(716) 878-3536
Mailing address
9 BIGELOW RD, CHEEKTOWAGA, NY 14225-1507
(716) 989-8119

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000671
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
734698967
DRIVERS LICENSE
NY
Enumeration date
09/10/2019
Last updated
11/27/2023
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