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NPI Code Detail

MEDICARE: CARLA UNIQUE ELLIS

MEDICARE: CARLA UNIQUE ELLIS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1699622167
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA UNIQUE ELLIS
Provider Business Mailing Address
First Line : 2311 SOUTHERN BLVD APT 1104
Second Line :
City : BRONX
State : NY
Zip : 10460-1091
Country : US
Telephone Number : 347-757-2936
Fax Number :
Provider Business Practice Location Address
First Line : 2311 SOUTHERN BLVD APT 1104
Second Line :
City : BRONX
State : NY
Zip : 10460-1091
Country : US
Telephone Number : 347-757-2936
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2026
Last Update Date : 03/13/2026

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Directions to “ CARLA UNIQUE ELLIS ” Practice Location

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