Individual
DR. JOHN ELLIE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1500 PORTLAND AVE, PODIATRY SUITE, ROCHESTER, NY 14621-3065
(585) 642-6100
(585) 642-6111
Mailing address
1500 PORTLAND AVE, PODIATRY/MED OFFICE, ROCHESTER, NY 14621
(585) 642-6100
(585) 642-6111
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
006649
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04203352
—
NY
05
—
05448155
—
NY
Enumeration date
06/25/2012
Last updated
03/17/2022
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