Ellis, David A
Ellis, David A is an individual health care provider with primary practice located at 315 S Manning Blvd Medical Imaging Department, Albany NY 12208-1707. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Ellis, David A can be contacted via phone (518) 525-1852.Contact Information
Primary practice address
315 S Manning Blvd Medical Imaging Department
Albany NY 12208-1707
Phone: (518) 525-1852
Fax: (518) 525-1559
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | 144672 | New York |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 144672 | New York |
Profile Details
| NPI number | 1952393175 |
|---|---|
| LBN Legal business name | Ellis, David A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | May 24th, 2012 - about 12 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 | 1952393175 | NPPES |
| New York | MEDICAID | 00797791 |
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