Organization
HENRIETTA PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILIE ELLICOTT DO (PHYSICIAN)
(585) 451-7014
Entity
Organization
Contact information
Practice address
1200 JEFFERSON RD STE 115, ROCHESTER, NY 14623-3158
(585) 601-2600
(585) 229-6008
Mailing address
10 LAWTON DR, PITTSFORD, NY 14534-3266
(585) 451-7014
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801110697
—
NY
Enumeration date
06/22/2021
Last updated
10/22/2021
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