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Individual

ELLEN C EBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
17 CLYDE RD, SOMERSET, NJ 08873-5041
(732) 873-1600
(732) 873-1606
Mailing address
17 CLYDE RD, SOMERSET, NJ 08873-5041
(732) 873-1600
(732) 873-1606

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA04369900
NJ
207RG0100X
Gastroenterology Physician
25MA04369900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0174602
NJ
Enumeration date
10/19/2006
Last updated
09/24/2013
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