Healthcare Provider Details

I. General information

NPI: 1134155906
Provider Name (Legal Business Name): ELLEN GINSBERG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 BARTOW AVE 227
BRONX NY
10475-4614
US

IV. Provider business mailing address

36 CHERRY HILL CT
BRIARCLIFF MANOR NY
10510-1245
US

V. Phone/Fax

Practice location:
  • Phone: 718-320-9000
  • Fax:
Mailing address:
  • Phone: 914-762-3490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number172644
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number172644-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: