Provider Demographics
NPI:1659701043
Name:MCDOWELL, ELLEN (MED)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:RAJOTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4872 HYDE RD
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-9499
Mailing Address - Country:US
Mailing Address - Phone:315-701-5710
Mailing Address - Fax:
Practice Address - Street 1:6575 KIRKVILLE RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9809
Practice Address - Country:US
Practice Address - Phone:315-701-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator