Ellis, Deandrea

Ellis, Deandrea is an individual health care provider with primary practice located at 1 Seymour Plaza , Montclair NJ 07042. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Ellis, Deandrea can be contacted via phone (973) 744-6939.

Contact Information

Primary practice address
1 Seymour Plaza Montclair NJ 07042
Phone: (973) 744-6939
Fax: (973) 744-0365
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA11142900 New Jersey
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1477057354
LBN Legal business name Ellis, Deandrea
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2018
Last updated Nov 8th, 2021 - about 4 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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