Organization
ROSWELL PARK CANCER INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANDACE JOHNSON PHD (PRESIDENT AND CEO)
(716) 845-5772
Entity
Organization
Contact information
Practice address
203 PARK CLUB LANE, SUITE Z-200, WILLIAMSVILLE, NY 14221
(716) 845-8936
Mailing address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001
(716) 845-5785
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354518
—
NY
Enumeration date
09/07/2023
Last updated
09/07/2023
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