Provider Demographics
NPI:1154335834
Name:ELSIGAN, JULIE A (PA-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:ELSIGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:ELSIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:135 N UNION ST
Mailing Address - Street 2:BLUE BIRD SQUARE
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2736
Mailing Address - Country:US
Mailing Address - Phone:716-375-7500
Mailing Address - Fax:716-701-6853
Practice Address - Street 1:135 N UNION ST
Practice Address - Street 2:BLUE BIRD SQUARE
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2736
Practice Address - Country:US
Practice Address - Phone:716-375-7500
Practice Address - Fax:716-701-6853
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005893363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000196648OtherUNIVERA
9512015OtherINDEPENDENT HEALTH
000570389005OtherBC/BS
NYJ400144742Medicare UPIN
P00129027Medicare ID - Type UnspecifiedRAILROAD MEDICARE #