Debra Lynn Roetzer
Individual provider Active NPI Specialist · Corfu, NY
NPI 1316208366 · NPPES record last updated Jun 6, 2012
Key facts
- NPI
- 1316208366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 1078 Sliker Rd
Corfu, NY 14036-9791 - Phone
- (716) 548-1149
- NPI assigned
- Jun 6, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
1078 Sliker Rd
Corfu, NY 14036-9791
Mailing address
1078 Sliker Rd
Corfu, NY 14036-9791
Phone (716) 548-1149
Other providers in Corfu, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.