Healthcare Provider Details

I. General information

NPI: 1154335834
Provider Name (Legal Business Name): JULIE A ELSIGAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE A ELSIGAN P.A.

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N UNION ST BLUE BIRD SQUARE
OLEAN NY
14760-2736
US

IV. Provider business mailing address

135 N UNION ST BLUE BIRD SQUARE
OLEAN NY
14760-2736
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-7500
  • Fax: 716-701-6853
Mailing address:
  • Phone: 716-375-7500
  • Fax: 716-701-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number005893
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: