Individual
DR. COLIN MICHAEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, ALBANY, NY 12208
(518) 525-1852
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
298810
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2013
Last updated
05/14/2021
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