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NPI Code Detail

MEDICARE: ELLIS HOSPITAL

MEDICARE: ELLIS HOSPITAL
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
1314000000XSkilled Nursing Facility4601001NNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10101OTHERNYMVP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
310005801OTHERNYCDPHP
4000400009002OTHERNYBSNENY
5007940OTHERNYEMIPIRE BC

General Provider Information

NPI Number : 1215928148
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELLIS HOSPITAL
Provider Business Mailing Address
First Line : 600 MCCLELLAN ST
Second Line :
City : SCHENECTADY
State : NY
Zip : 12304-1009
Country : US
Telephone Number : 518-382-2250
Fax Number : 518-382-2206
Provider Business Practice Location Address
First Line : 600 MCCLELLAN ST
Second Line :
City : SCHENECTADY
State : NY
Zip : 12304-1009
Country : US
Telephone Number : 518-382-2250
Fax Number : 518-382-2206
Authorized Official
Title or Position : CEO
Name : MR. JAMES CONNOLLY
Credential :
Telephone Number : 518-243-4141
Provider Enumeration Date : 10/31/2005
Last Update Date : 03/27/2012

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Directions to “ELLIS HOSPITAL ” Practice Location

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