Fennell, Jill

Fennell, Jill is an sole proprietor health care provider with primary practice located at 818 Ellicott St , Buffalo NY 14203-1021. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Fennell, Jill can be contacted via phone (716) 323-0034.

Contact Information

Primary practice address
818 Ellicott St Buffalo NY 14203-1021
Phone: (716) 323-0034
Fax: (716) 323-0292
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 290206 New York
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 290206 New York

Profile Details

NPI number 1689084485
LBN Legal business name Fennell, Jill
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2014
Last updated Jan 13th, 2021 - about 3 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 1689084485 NPPES
New York MEDICAID 05953255

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