Individual
LORI J ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
260 E MIDDLE COUNTRY RD, SUITE 107, SMITHTOWN, NY 11787-2982
(631) 979-7222
Mailing address
260 E MIDDLE COUNTRY RD, SMITHTOWN, NY 11787-2982
(631) 979-7222
(631) 638-4170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
264115
NY
Other
Enumeration date
05/15/2009
Last updated
05/07/2022
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