Individual
JAY M ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 WENDELL AVE, PITTSFIELD, MA 01201-6941
(413) 499-7128
(413) 447-1926
Mailing address
100 WENDELL AVE, PITTSFIELD, MA 01201-6941
(413) 499-7128
(413) 447-1926
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
40812
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2051842
—
MA
Enumeration date
10/16/2006
Last updated
03/11/2011
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