Individual
CHARLI ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 726-8610
Mailing address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 726-8610
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
316745
NY
Other
Enumeration date
07/06/2010
Last updated
07/26/2024
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