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General NPI Number Information
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NPI Number | 1124880133
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Entity Type | Organization
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Legal Business Name | ELLIS HOSPITAL
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 2210 TROY SCHENECTADY RD
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City | NISKAYUNA
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State | NY
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Zip | 12309-4725
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Country | US
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Telephone | 518-346-9400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1022
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City | SCHENECTADY
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State | NY
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Zip | 12301-1022
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER ACCOUNT RECEIVABLE
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Name | CYNTHIA ANN WICKS
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Credential |
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Telephone | 518-382-2313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NW0100X
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Taxonomy Name | Women's Hospital
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License Number |
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License Number State |
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