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General NPI Number Information
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NPI Number | 1609867100
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Entity Type | Individual
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Provider Name | ELLEN LOUISE CONNER MD
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Gender | Female
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 19 DAVIS AVE FL 7
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City | NEPTUNE
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State | NJ
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Zip | 07753-4488
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Country | US
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Telephone | 732-776-3797
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Fax | 732-776-3796
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Provider Business Mailing Address
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Address Line | 19 DAVIS AVE FL 7
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City | NEPTUNE
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State | NJ
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Zip | 07753-4488
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Country | US
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Telephone | 732-776-3797
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Fax | 732-776-3796
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA07702900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 25MA07702900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 25MA07702900
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License Number State | NJ
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