Individual
ELLEN BIRENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10 UNION SQUARE E, NEW YORK, NY 10003
(212) 420-3494
Mailing address
PO BOX 95000-2433, PHILADELPHIA, PA 19195-2433
(212) 420-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
150923
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00806551
—
NY
Enumeration date
01/26/2006
Last updated
08/17/2012
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