Individual
MONICA E FELLENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
275 THOMAS INDIAN SCHOOL DR, IRVING, NY 14081-9341
(716) 532-5582
(716) 242-6344
Mailing address
987 R C HOAG DR, SALAMANCA, NY 14779-1365
(716) 532-5582
(716) 242-6345
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008548
NY
363AM0700X
Medical Physician Assistant
Primary
008548
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000528450001
WNYBCBS
NY
05
—
03479792
—
NY
01
—
060822000001
FIDELIS CARE NEW YORK
NY
01
—
9513195
INDEPENDENT HEALTH
NY
Enumeration date
10/04/2006
Last updated
05/12/2025
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