Individual
MRS. COREY E ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1184 STATE ROUTE 50, BALLSTON LAKE, NY 12019-1923
(518) 384-1281
(518) 384-0321
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2015
Last updated
10/17/2022
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