Ellis, Jennifer Lynn

Ellis, Jennifer Lynn is an individual health care provider with primary practice located at 601 Elmwood Avenue Box 652, Rochester NY 14642-8410. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Ellis, Jennifer Lynn can be contacted via phone (585) 279-5100.

Contact Information

Primary practice address
601 Elmwood Avenue Box 652 Rochester NY 14642-8410
Phone: (585) 279-5100
Fax: (585) 756-7752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 262312 New York

Profile Details

NPI number 1720281991
LBN Legal business name Ellis, Jennifer Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2007
Last updated Jul 6th, 2023 - about last year

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 1720281991 NPPES
New York MEDICAID 03383828

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