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NPI Code Detail

MEDICARE: ANN ELIZABETH ERNST MS, PT

MEDICARE: ANN ELIZABETH ERNST MS, PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical Therapist022155NY
22251P0200XPediatric Physical Therapist022155-1NY
3225100000XPhysical Therapist022155-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P020022155OTHERBLUE CROSS BLUE SHIELD
2P010022155OTHERBLUE CHOICE
3P010022155OTHERRIPA
4022155OTHERMONROE PLAN

General Provider Information

NPI Number : 1124163274
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN ELIZABETH ERNST MS, PT
Provider Business Mailing Address
First Line : 41 OCONNOR RD
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-1327
Country : US
Telephone Number : 585-383-2216
Fax Number :
Provider Business Practice Location Address
First Line : 41 OCONNOR RD
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-1327
Country : US
Telephone Number : 585-377-4660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 01/27/2023

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