Individual
ELLEN J DART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
961 COUNTY ROUTE 31, GLEN SPEY, NY 12737-5828
(845) 856-3789
Mailing address
PO BOX 359, GLEN SPEY, NY 12737-0359
(845) 856-3789
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
4781121
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4781121
RN LIC NBR
NY
Enumeration date
02/01/2020
Last updated
02/01/2020
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