Individual
ASHLEY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
48 CRESCENT COVE CT, SEAFORD, NY 11783-3648
(516) 477-0713
Mailing address
48 CRESCENT COVE CT, SEAFORD, NY 11783-3648
(516) 477-0713
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
027988
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/11/2021
Last updated
02/15/2022
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