Ellis, Stephen J.
Ellis, Stephen J. is an individual health care provider with primary practice located at 210 Jack Martin Blvd Suite D-1, Brick NJ 08724-7771. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ellis, Stephen J. can be contacted via phone (732) 458-5067.Contact Information
Primary practice address
210 Jack Martin Blvd Suite D-1
Brick NJ 08724-7771
Phone: (732) 458-5067
Fax: (732) 458-4962
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 25MA03904800 | New Jersey |
Profile Details
| NPI number | 1801831854 |
|---|---|
| LBN Legal business name | Ellis, Stephen J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Oct 17th, 2014 - about 11 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 | 1801831854 | NPPES |
| New Jersey | MEDICAID | 4871405 | |
| New Jersey | Other | 390003718 |
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