Ellicottville Medical
Pediatrics
Ellicottville Medical is a Ellicottville, New York based Pediatric center with medical specialization in
General Pediatrics.
It is located at
5 Park Sq, Ellicottville, New York - 14731-7014. They can be contacted on phone at
716-257-4397.
NPI number (Unique professional ID) for Ellicottville Medical is
1902566748 which was assigned by NPPES on 21 Dec, 2021 and it was last updated on 21 Dec, 2021.
Ellicottville Medical is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Ellicottville Medical basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Ellicottville Medical |
|---|
Business Address:
Ellicottville Medical address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 5 Park Sq
Ellicottville, NY, 14731-7014
United States |
|---|
| Phone Number : | 716-257-4397 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1902566748 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 21 Dec, 2021 |
|---|
| Last Updated On : | 21 Dec, 2021 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Katelyn Johnson-clark |
|---|
| Authorized Official Credential : | DO |
|---|
| Official Title or Position : | OWNER |
|---|
| Phone Number : | 941-441-7804 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ellicottville Medical are as mentioned. Primary taxonomy code for Ellicottville Medical is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Ellicottville Medical such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 261977 | Other | NY | NYS MEDICAL LICENSE NUMBER |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | drkate@homegrownpeds.com
| No affiliation |
|
| 5 PARK SQ,
ELLICOTTVILLE, NY, 14731-7014
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 1252
Ellicottville, NY, 14731-1252
United States |
|---|
| Phone Number : | 716-257-4397 |
|---|
Business Location:
Patients can refer following map for directions to
Ellicottville Medical practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.