Individual
BONNIE M ROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
620 TRONOLONE PL, NIAGARA FALLS, NY 14301-1910
(716) 205-0825
Mailing address
525 WASHINGTON ST, BUFFALO, NY 14203-1711
(716) 853-4424
(716) 332-2820
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000506354003
BCBS OF WNY
NY
Enumeration date
12/04/2007
Last updated
12/04/2007
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