Ellis, Jay M
Ellis, Jay M is an sole proprietor health care provider with primary practice located at 100 Wendell Ave , Pittsfield MA 01201-6941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Ellis, Jay M can be contacted via phone (413) 499-7128.Contact Information
Primary practice address
100 Wendell Ave
Pittsfield MA 01201-6941
Phone: (413) 499-7128
Fax: (413) 447-1926
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 40812 | Massachusetts |
Profile Details
| NPI number | 1558441790 |
|---|---|
| LBN Legal business name | Ellis, Jay M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Mar 11th, 2011 - about 14 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 | 1558441790 | NPPES |
| Massachusetts | MEDICAID | 2051842 |
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