DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: TRACY MOTTLEY ELLIS

MEDICARE: TRACY MOTTLEY ELLIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseN18190-01NY

General Provider Information

NPI Number : 1053240929
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY MOTTLEY ELLIS
Provider Business Mailing Address
First Line : 135 BROAD ST
Second Line :
City : MATAWAN
State : NJ
Zip : 07747-3133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1915 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2127
Country : US
Telephone Number : 718-981-3136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

Similar Medicare Providers

1548381767 — SAMARITAN DAYTOP VILLAGE, INC.
Practice Location Address:
1915 FOREST AVE
STATEN ISLAND, NY
10303-2127
Practice Phone: 718-981-3136
Practice Fax: 718-981-6849
1184882888 — MS. JEAN A. JOHN L.M.S.W.
Practice Location Address:
1915 FOREST AVE
STATEN ISLAND, NY
10303-2127
Practice Phone: 718-981-3136
Practice Fax:
1518125228 — MS. CHERYL L. NAZARIO C.A.S.A.C.
Practice Location Address:
1915 FOREST AVE
STATEN ISLAND, NY
10303-2127
Practice Phone: 718-981-3270
Practice Fax:
1306004015 — MS. NORMA P. MITCHELL C.A.S.A.C.
Practice Location Address:
1915 FOREST AVE
STATEN ISLAND, NY
10303-2127
Practice Phone: 718-981-3136
Practice Fax:
1639401813 — SHARON B. SPERBER LMSW
Practice Location Address:
1915 FOREST AVE
STATEN ISLAND, NY
10303-2127
Practice Phone: 718-981-3136
Practice Fax:
1285062026 — MS. ALEXIS PADOVANO CASAC
Practice Location Address:
1915 FOREST AVE
STATEN ISLAND, NY
10303-2127
Practice Phone: 718-981-3136
Practice Fax:

Directions to “ TRACY MOTTLEY ELLIS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.