Ellenbogen, Enrique

Ellenbogen, Enrique is an sole proprietor health care provider with primary practice located at 700 S Stanfield Rd Suite B, Troy OH 45373-2569. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Ellenbogen, Enrique can be contacted via phone (937) 335-7121.

Contact Information

Primary practice address
700 S Stanfield Rd Suite B Troy OH 45373-2569
Phone: (937) 335-7121
Fax: (937) 335-7124
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 35100246 Ohio

Profile Details

NPI number 1972671709
LBN Legal business name Ellenbogen, Enrique
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2006
Last updated Jan 18th, 2012 - about 13 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 1972671709 NPPES
Ohio MEDICAID L0277598
Ohio Other 000000010310
Ohio Other 311024334
Ohio Other D00246

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