Organization
ANESTHESIA AFFILIATE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ELLIE SR. MD (PRESIDENT)
(716) 634-4798
Entity
Organization
Contact information
Practice address
4302 MEDICAL CENTER DR., SUITE 302, FAYETTEVILLE, NY 13066-6625
(315) 422-2222
(716) 634-0987
Mailing address
338 HARRIS HILL RD, SUITE 207, WILLIAMSVILLE, NY 14221-7407
(716) 634-4798
(716) 634-0987
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
142491-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02410011
—
NY
Enumeration date
09/26/2006
Last updated
05/19/2022
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