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General NPI Number Information
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NPI Number | 1215467386
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Entity Type | Organization
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Legal Business Name | ELLIS CONSULTING INC.
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 30 CENTRAL PARK S RM 7A
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City | NEW YORK
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State | NY
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Zip | 10019-1628
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Country | US
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Telephone | 212-753-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 30 CENTRAL PARK S RM 7A
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City | NEW YORK
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State | NY
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Zip | 10019-1628
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Country | US
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Telephone | 212-753-1119
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDA ELLIS
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Credential |
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Telephone | 212-753-1119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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