Ellis, John M

Ellis, John M is an individual health care provider with primary practice located at 1656 Champlin Ave , Utica NY 13502-4830. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Ellis, John M can be contacted via phone (315) 624-6116.

Contact Information

Primary practice address
1656 Champlin Ave Utica NY 13502-4830
Phone: (315) 624-6116
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 209356 New York

Profile Details

NPI number 1962464818
LBN Legal business name Ellis, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated May 1st, 2023 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1962464818 NPPES
New York Other P010209356 BCBS
New York Other 300099765 BCBS
New York MEDICAID 01874611 BCBS
New York Other 4199650 BCBS
New York Other 040426013962 BCBS
New York Other 960976 BCBS
New York Other 209356-1 BCBS
New York Other 10037625 BCBS

Popular Providers