Jill Fennell, | |
818 Ellicott St, Buffalo, NY 14203-1021 | |
(716) 323-0034 | |
(716) 323-0292 |
Full Name | Jill Fennell |
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Gender | Female |
Speciality | Hospitalist |
Location | 818 Ellicott St, Buffalo, 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 |
---|---|---|---|
1689084485 | NPI | - | NPPES |
05953255 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0204X | Pediatrics - Pediatric Emergency Medicine | 290206 (New York) | Secondary |
208M00000X | Hospitalist | 290206 (New York) | Primary |
Entity Name | University At Buffalo Pediatric Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912928599 PECOS PAC ID: 1355235540 Enrollment ID: O20040210000076 |
Mailing Address | Practice Location Address |
---|---|
Jill Fennell, 1001 Main St Fl 5, Buffalo, NY 14203-1009 Ph: (716) 323-0034 | Jill Fennell, 818 Ellicott St, Buffalo, NY 14203-1021 Ph: (716) 323-0034 |
Nirmit Dilipkumar Kothari, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 462 Grider St, Room 786, Buffalo, NY 14215 Phone: 716-961-6995 Fax: 716-898-5276 | |
Ryan Stehlin, DNP Hospitalist Medicare: Not Enrolled in Medicare Practice Location: 100 High St, Buffalo, NY 14203 Phone: 716-859-3508 | |
Dr. Fatemeh Moslehi, M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 462 Grider St, Buffalo, NY 14215 Phone: 716-898-4226 | |
Dr. Romel Adupe Bertulfo, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 565 Abbott Rd, Rm. 8-632, Buffalo, NY 14220 Phone: 716-828-2434 Fax: 726-828-3417 | |
David Lee Pierce, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 462 Grider St, Buffalo, NY 14215 Phone: 716-898-3000 | |
Mamoon Bokhari, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: Elm And Carlton Streets, Buffalo, NY 14263 Phone: 716-845-2300 Fax: 716-845-1110 | |
Peter Ewing, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 100 High St, Buffalo, NY 14203 Phone: 716-859-2259 |