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Individual
PRASHULA ELLSWORTH
Active
Individual
PRASHULA ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007118-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026513001
UNIVERA
NY
01
—
000570254007
HEALTH NOW
NY
01
—
161000580
NOVA
NY
01
—
9512316
IHA
NY
Enumeration date
07/30/2006
Last updated
09/21/2011
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