Basic Information
Provider Information
NPI: 1336445097
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROLOFF
FirstName: PAMELA
MiddleName: ROBIN
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 392 PEARL ST
Address2: SUITE 400
City: BUFFALO
State: NY
PostalCode: 142022202
CountryCode: US
TelephoneNumber: 7168834578
FaxNumber: 8669414302
Practice Location
Address1: 392 PEARL ST
Address2: SUITE 400
City: BUFFALO
State: NY
PostalCode: 142022202
CountryCode: US
TelephoneNumber: 7168834578
FaxNumber: 8669414302
Other Information
ProviderEnumerationDate: 01/28/2011
LastUpdateDate: 01/28/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X516357ANYY Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home