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General NPI Number Information
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NPI Number | 1992702575
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Entity Type | Individual
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Provider Name | MARK ELLIS GINSBURG MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 161 FORT WASHINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10032-3729
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Country | US
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Telephone | 212-305-3408
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Fax |
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Provider Business Mailing Address
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Address Line | 5A MEDICAL PARK DR
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City | POMONA
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State | NY
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Zip | 10970-3516
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Country | US
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Telephone | 845-362-0075
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Fax | 845-362-1716
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 147810
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License Number State | NY
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