Ellwood, Richard John
Ellwood, Richard John is an sole proprietor health care provider with primary practice located at 222 Merrick Ave , Merrick NY 11566-3143. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ellwood, Richard John can be contacted via phone (516) 379-4444.Contact Information
Primary practice address
222 Merrick Ave
Merrick NY 11566-3143
Phone: (516) 379-4444
Fax: (516) 867-7196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 031915-1 | New York |
Profile Details
| NPI number | 1265644116 |
|---|---|
| LBN Legal business name | Ellwood, Richard John |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265644116 | NPPES |
| New York | MEDICAID | 00425461 |
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