Healthcare Provider Details

I. General information

NPI: 1285728501
Provider Name (Legal Business Name): ELLIS J. ARNSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 SELWYN AVE SUITE #6D
BRONX NY
10457-7626
US

IV. Provider business mailing address

1650 SELWYN AVE SUITE #6D
BRONX NY
10457-7626
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-7337
  • Fax: 718-518-5124
Mailing address:
  • Phone: 718-960-1373
  • Fax: 718-518-5124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number146022
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: