Individual
DR. PATRICK T ELLINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
55 FRUIT ST, GRB 109 ELECTROPHYSIOLOGY LAB ARRHYTHMIA SERVICE, BOSTON, MA 02114-2621
(617) 726-4959
(617) 726-3952
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-4959
(617) 726-3852
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
157045
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3200566
—
MA
01
—
405901
TUFTS HEALTH PLAN
MA
01
—
J21743
BCBS MA
MA
Enumeration date
11/29/2005
Last updated
09/13/2022
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