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General NPI Number Information
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NPI Number | 1871706721
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Entity Type | Organization
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Legal Business Name | FINGER LAKES EMERGENCY PHYSICIAN SERVICES PLLC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2300 BUFFALO RD BLDG # 900
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City | ROCHESTER
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State | NY
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Zip | 14624-1360
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Country | US
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Telephone | 585-426-4990
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Fax |
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Provider Business Mailing Address
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Address Line | 345 COUNTRY WOODS LN
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City | ROCHESTER
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State | NY
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Zip | 14626-4701
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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 | CEO
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Name | DR. C JAY ELLIE JR.
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Credential | MD
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Telephone | 585-225-9230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 1913411
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License Number State | NY
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