Ellis, Eugene

Ellis, Eugene is an individual health care provider with primary practice located at 967 48Th St , Brooklyn NY 11219-2919. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ellis, Eugene can be contacted via phone (718) 283-3000.

Contact Information

Primary practice address
967 48Th St Brooklyn NY 11219-2919
Phone: (718) 283-3000
Fax: (718) 238-6818
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 136939-1 New York

Profile Details

NPI number 1194721142
LBN Legal business name Ellis, Eugene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Dec 8th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194721142 NPPES
New York MEDICAID 01862853

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