Provider Demographics
NPI:1871557660
Name:EBLING, ANN MARIE (NP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:EBLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 PITTSFORD VICTOR RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3812
Mailing Address - Country:US
Mailing Address - Phone:585-383-4040
Mailing Address - Fax:585-383-4051
Practice Address - Street 1:1050 PITTSFORD VICTOR RD BLDG B
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3812
Practice Address - Country:US
Practice Address - Phone:585-383-4040
Practice Address - Fax:585-383-4051
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3021821363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2359584Medicaid
NY2359584Medicaid