Provider Demographics
NPI:1881038743
Name:ROSWELL PARK CANCER INSTITUTE
Entity Type:Organization
Organization Name:ROSWELL PARK CANCER INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-845-8433
Mailing Address - Street 1:CARLTON BUILDING
Mailing Address - Street 2:ELM AND CARLTON STREET
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARLTON BUILDING
Practice Address - Street 2:ELM AND CARLTON STREET
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-8433
Practice Address - Fax:716-845-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital