MEDICARE: ELSSY N. OMS MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1336856319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELSSY N. OMS MD PA

Provider Business Mailing Address
First Line	:	400 S AUSTRALIAN AVE STE 422
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5004
Country	:	US
Telephone Number	:	786-853-9159
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S AUSTRALIAN AVE STE 422
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5004
Country	:	US
Telephone Number	:	561-295-7070
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELSSY OMS
Credential	:	MD
Telephone Number	:	786-853-9159

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	11/09/2022

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