Individual
MR. CARL PAUL ELLERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, PH.D.
Contact information
Practice address
6315 FLY RD, SUITE 106, EAST SYRACUSE, NY 13057-9316
(315) 437-1687
(315) 437-1686
Mailing address
6315 FLY RD, SUITE 106, EAST SYRACUSE, NY 13057-9316
(315) 437-1687
(315) 437-1686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R043185
NY
Other
Enumeration date
07/20/2008
Last updated
07/20/2008
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