Individual
ELLEN MELLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 E 57TH ST, STE 510, NEW YORK, NY 10022-2221
(212) 838-4114
(212) 838-4145
Mailing address
121 E 60TH ST, #2C, NEW YORK, NY 10022-1117
(212) 838-4114
(212) 838-4145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
146454
NY
207RC0000X
Cardiovascular Disease Physician
146454
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01166449
—
NY
Enumeration date
08/11/2005
Last updated
11/10/2017
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