Charles, Ellis B
Charles, Ellis B is an sole proprietor health care provider with primary practice located at 90 Washington St , East Orange NJ 07017-1050. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Charles, Ellis B can be contacted via phone (973) 672-2555.Contact Information
Primary practice address
90 Washington St
East Orange NJ 07017-1050
Phone: (973) 672-2555
Fax: (973) 672-2529
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 132910 | New York |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 25MA05127300 | New Jersey |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 18284 | Georgia |
Profile Details
| NPI number | 1013046341 |
|---|---|
| LBN Legal business name | Charles, Ellis B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 4th, 2007 |
| Last updated | Mar 5th, 2013 - about 11 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 | 1013046341 | NPPES |
| New Jersey | MEDICAID | 0866300 |
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