Individual
DR. PETER ELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 TECHNOLOGY DR, EAST SETAUKET, NY 11733
(631) 444-5220
Mailing address
P.O. BOX 1559, STONY BROOK, NY 11790
(631) 444-5220
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
147471
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00640831
—
NY
01
—
4309111
AETNA
NY
01
—
56A963
EMPIRE BC.BS
NY
Enumeration date
07/11/2006
Last updated
01/04/2013
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