Provider Demographics
NPI:1467528802
Name:ROFFMAN, WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:ROFFMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LOCH REVAN HTS
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3302
Mailing Address - Country:US
Mailing Address - Phone:585-338-3885
Mailing Address - Fax:
Practice Address - Street 1:2 SPENCERPORT RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-5206
Practice Address - Country:US
Practice Address - Phone:585-247-3473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027345OtherPHARMACY LICENSE