National Provider Identifier
John Ellie Jr., D.P.M.
John Ellie Jr., D.P.M. is listed in the NPPES registry with a primary specialty of Foot & Ankle Surgery Podiatrist in Rochester, NY and a listed phone number of (585) 642-6100.
Profile Overview
- NPI
- 1427311455
- Provider Type
- Individual
- Primary Specialty
- Foot & Ankle Surgery Podiatrist
- Enumeration Date
- June 25, 2012
- Last Updated
- March 17, 2022
Practice Location
- 1500 Portland Ave
- Podiatry Suite
- Rochester, NY 14621-3065
Phone: (585) 642-6100
Mailing Address
- 1500 Portland Ave
- Podiatry/Med Office
- Rochester, NY 14621
Specialties
- Foot & Ankle Surgery Podiatrist (213ES0103X)
Full Record
- NPI
- 1427311455
- Entity Type
- Individual
- Last Name
- Ellie
- First Name
- John
- Name Prefix
- Dr.
- Name Suffix
- Jr.
- Credential
- D.P.M.
- Mailing Street Address
- 1500 Portland Ave
- Mailing Address Line 2
- Podiatry/Med Office
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621
- Mailing Country
- US
- Mailing Phone
- (585) 642-6100
- Mailing Fax
- (585) 642-6111
- Practice Street Address
- 1500 Portland Ave
- Practice Address Line 2
- Podiatry Suite
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3065
- Practice Country
- US
- Practice Phone
- (585) 642-6100
- Practice Fax
- (585) 642-6111
- Enumeration Date
- June 25, 2012
- Last Updated
- March 17, 2022
- Sex
- Male
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- March 06, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Foot & Ankle Surgery Podiatrist (213ES0103X)
- Other Identifiers
- 05448155 (NY), 04203352 (NY)