Individual
ASHLEY ELOISE RE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
818 ELLICOTT ST, BUFFALO, NY 14203-1021
(716) 323-2000
Mailing address
818 ELLICOTT ST, BUFFALO, NY 14203-1021
(716) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016899
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026794502
UNIVERA
NY
05
—
03746325
—
NY
01
—
150624000031
FIDELIS
NY
01
—
PAR
BC OF WNY
NY
Enumeration date
09/11/2013
Last updated
11/11/2019
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