Individual
DR. NITZA F ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1131 DELAWARE AVE, BUFFALO, NY 14209-1603
(716) 884-0230
(716) 884-2415
Mailing address
1131 DELAWARE AVE, BUFFALO, NY 14209-1603
(716) 884-0230
(716) 884-2415
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
137951
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010050901
UNIVERA
NY
05
—
01029556
—
NY
01
—
1206842
INDEPENDENT HEALTH ASSOC
NY
Enumeration date
12/15/2005
Last updated
07/08/2007
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