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Individual
MARY ELLEN ANDOLSEK
Active
Individual
MARY ELLEN ANDOLSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
400848
NY
363A00000X
Physician Assistant
Primary
F400848-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02595206
—
NY
Enumeration date
06/26/2006
Last updated
07/05/2023
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