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Individual

DR. GILAD ELLENBERG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8601 HOMELAWN ST, JAMAICA, NY 11432-2635
(718) 739-0355
Mailing address
68 PICCADILLY RD, GREAT NECK, NY 11023-1547
(516) 773-3399

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
127287-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00467827
NY
Enumeration date
06/17/2006
Last updated
07/08/2007
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