Organization
SCOTT JACOB ELLIS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT JACOB ELLIS MD (PRESIDENT)
(646) 797-8305
Entity
Organization
Contact information
Practice address
523 E 72ND ST FL 5, NEW YORK, NY 10021-4099
(646) 797-8305
(646) 797-8515
Mailing address
PO BOX 12184, HAUPPAUGE, NY 11788-0854
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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