Provider Demographics
NPI:1043715519
Name:ELSAESSER, ASHLEY (MT, ASCP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ELSAESSER
Suffix:
Gender:F
Credentials:MT, ASCP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ROHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT, ASCP
Mailing Address - Street 1:37 CROWN POINT LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3495 BAILEY AVEENUE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-862-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018205-1246QM0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMicrobiology