Ellis, John S
Ellis, John S is an individual health care provider with primary practice located at 691 Route 9 S Millers Mall - Unit 4, Little Egg Harbor Twp NJ 08087-4020. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ellis, John S can be contacted via phone (609) 294-8144.Contact Information
Primary practice address
691 Route 9 S Millers Mall - Unit 4
Little Egg Harbor Twp NJ 08087-4020
Phone: (609) 294-8144
Fax: (609) 812-5190
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OA05056 | New Jersey |
Profile Details
| NPI number | 1871569244 |
|---|---|
| LBN Legal business name | Ellis, John S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2006 |
| Last updated | Feb 10th, 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 | 1871569244 | NPPES |
| New Jersey | Other | 630717YCT | MEDICARE PTAN |
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