Individual
DR. JENNIFER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 1ST AVE STE 9V, NEW YORK, NY 10016-6402
(212) 263-0692
(212) 263-2042
Mailing address
530 1ST AVE STE 9V, NEW YORK, NY 10016-6402
(212) 263-0692
(212) 263-2042
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD33788
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039911400
—
DC
Enumeration date
07/26/2006
Last updated
04/06/2023
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