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Individual

DR. JOHN ELLIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7470
(716) 634-4798
(716) 634-0987
Mailing address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7470
(716) 634-4798
(716) 634-0987

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
142491-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00808080
NY
Enumeration date
08/04/2006
Last updated
06/29/2010
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