Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellicottville Medical

Organization Pediatrics Physician · NPI 1902566748

Ellicottville Medical is a Pediatrics Physician in Ellicottville, New York. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

5 Park Sq
Ellicottville, NY 14731-7014
Phone: (716) 257-4397
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1902566748
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Katelyn Johnson-Clark — Owner · (941) 441-7804
NPI enumeratedDecember 21, 2021
Last updated in NPPESDecember 21, 2021
Certification dateDecember 21, 2021
Mailing addressPo Box 1252, Ellicottville, NY 14731-1252

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