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General NPI Number Information
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NPI Number | 1497949622
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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 | 08/30/2007
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 1023 STATE ST
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City | SCHENECTADY
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State | NY
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Zip | 12307-1511
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Country | US
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Telephone | 518-243-3300
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Fax | 518-377-9151
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Provider Business Mailing Address
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Address Line | 1023 STATE ST
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City | SCHENECTADY
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State | NY
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Zip | 12307-1511
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Country | US
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Telephone | 518-243-3300
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Fax | 518-377-9151
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Authorized Official
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Title or Position | CEO
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Name | PAUL A MILTON
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Credential |
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Telephone | 518-243-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 6525110A
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License Number State | NY
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