Ellis, David J
Ellis, David J is an individual health care provider with primary practice located at 70 Hatfield Ln Ste 204, Goshen NY 10924-6735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Ellis, David J can be contacted via phone (845) 291-1260.Contact Information
Primary practice address
70 Hatfield Ln Ste 204
Goshen NY 10924-6735
Phone: (845) 291-1260
Fax: (845) 294-2312
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 180343 | New York |
Profile Details
| NPI number | 1891792214 |
|---|---|
| LBN Legal business name | Ellis, David J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Sep 27th, 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 | 1891792214 | NPPES |
| Other | 18N881L663 | MEDICARE | |
| MEDICAID | 01852446 | MEDICARE |
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