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Individual

BRENNAN ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6202
(315) 464-9501
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6202
(315) 464-9501

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
256992
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03248175
NY
01
P00890823
RAILROAD MEDICARE
NY
Enumeration date
06/11/2007
Last updated
04/08/2011
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