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General NPI Number Information
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NPI Number | 1700994522
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Entity Type | Individual
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Provider Name | GARNETTA MCCOY ELY MD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3170 WEST ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1712
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Country | US
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Telephone | 585-396-6190
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Fax | 585-396-6191
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Provider Business Mailing Address
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Address Line | 12 SAVANNAH CT
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City | ROCHESTER
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State | NY
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Zip | 14625-2926
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 157013
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License Number State | NY
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