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:
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Health care specialties

SpecialtyCodeLicense #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 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871569244 NPPES
New Jersey Other 630717YCT MEDICARE PTAN

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