Individual
ELLIS PRATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2818 ASTORIA BLVD, ASTORIA, NY 11102-4751
(917) 410-6905
Mailing address
36 1ST AVE, BOSTON, MA 02129-4557
(413) 687-5911
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
421714
NY
Other
Enumeration date
08/16/2023
Last updated
01/24/2024
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