Ellis, Jamie L

Ellis, Jamie L is an individual health care provider with primary practice located at 161 Carey Rd , Queensbury NY 12804-7821. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Ellis, Jamie L can be contacted via phone (518) 824-8610.

Contact Information

Primary practice address
161 Carey Rd Queensbury NY 12804-7821
Phone: (518) 824-8610
Fax: (518) 824-2390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F400698 New York

Profile Details

NPI number 1508806779
LBN Legal business name Ellis, Jamie L
Credentials NPP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Dec 2nd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508806779 NPPES
New York MEDICAID 02347437

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