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General NPI Number Information
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NPI Number | 1013263680
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Entity Type | Organization
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Legal Business Name | ELLISTON AND NG, MD, LLC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 1050 5TH AVE SUITE 1
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City | NEW YORK
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State | NY
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Zip | 10028-0110
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Country | US
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Telephone | 917-397-2268
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Fax | 917-397-2268
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Provider Business Mailing Address
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Address Line | 1050 5TH AVE SUITE 1
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City | NEW YORK
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State | NY
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Zip | 10028-0110
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Country | US
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Telephone | 917-397-2268
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Fax | 917-397-2268
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Authorized Official
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Title or Position | PARTNER
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Name | DR. LAUREN NOELLE ELLISTON
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Credential | MD
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Telephone | 917-397-2268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 262869
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License Number State | NY
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