Individual
CHERYL ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 GENESEE ST, UTICA, NY 13502-5635
(315) 797-7050
Mailing address
108 EXPENSE ST, ROME, NY 13440-3932
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280638
NY
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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