| Dr Carmen Jay Ellie Jr, MD | |
| 
					191 N Main St, Wellsville, NY 14895-1150  | |
| (585) 235-1514 | |
| (585) 426-4997 | 
| Full Name | Dr Carmen Jay Ellie Jr | 
|---|---|
| Gender | Male | 
| Speciality | Emergency Medicine - Emergency Medical Services | 
| Location | 191 N Main St, Wellsville, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1922042225 | NPI | - | NPPES | 
| 110179566 | Other | NY | RRM LEGACY# | 
| 000523980003 | Other | NY | BCBS | 
| 01487365 | Medicaid | NY | |
| P00392597 | Other | NY | RAILROAD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 191341-1 (New York) | Primary | 
| Entity Name | Carthage Area Hospital Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053497388 PECOS PAC ID: 9931010485 Enrollment ID: O20040209000856  | 
| Entity Name | The Memorial Hospital Of William F And Gertrude F Jones Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720030703 PECOS PAC ID: 7012828486 Enrollment ID: O20040310000938  | 
| Entity Name | Delphi Hospitalist Services Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1922270420 PECOS PAC ID: 5395819478 Enrollment ID: O20080807000352  | 
| Entity Name | Delphi Healthcare Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1003075029 PECOS PAC ID: 9537229661 Enrollment ID: O20081119000839  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Carmen Jay Ellie Jr, MD 345 Country Woods Ln, Rochester, NY 14626-4701 Ph: (585) 225-9230  | Dr Carmen Jay Ellie Jr, MD 191 N Main St, Wellsville, NY 14895-1150 Ph: (585) 235-1514  | 
Dr. Tamara Ann Prull, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 191 N Main St, Wellsville, NY 14895 Phone: 585-247-6810 Fax: 315-589-9406  | |
Dr. Chiemeka Joseph Nwokonko, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 191 N Main St, Wellsville, NY 14895 Phone: 585-247-6810 Fax: 315-589-9406  |