Provider Demographics
NPI:1801193693
Name:BERBARY, ROSLYN ANN
Entity Type:Individual
Prefix:MRS
First Name:ROSLYN
Middle Name:ANN
Last Name:BERBARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1924
Mailing Address - Country:US
Mailing Address - Phone:716-833-2306
Mailing Address - Fax:
Practice Address - Street 1:444 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1924
Practice Address - Country:US
Practice Address - Phone:716-833-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0017341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist