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Individual

MS. EMILIE ELLICOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1200 JEFFERSON RD, SUITE 115, ROCHESTER, NY 14623
(585) 601-2600
(585) 229-6008
Mailing address
1200 JEFFERSON RD, SUITE 115, ROCHESTER, NY 14623
(585) 601-2600
(585) 229-6008

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
270080
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03872891
NY
Enumeration date
03/23/2010
Last updated
01/19/2024
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