Individual
JOSEPHINE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2561 LAC DE VILLE BLVD, SUITE 202, ROCHESTER, NY 14618-5645
(585) 244-7330
(585) 244-6958
Mailing address
2561 LAC DE VILLE BLVD, SUITE 202, ROCHESTER, NY 14618-5645
(585) 244-7330
(585) 244-6958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
266694
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02862655
—
NY
Enumeration date
01/08/2007
Last updated
02/27/2018
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