Organization
ELLIS HOSPITAL
Active
Parent organization
ELLIS HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIS HOSPITAL
Authorized official
PAUL A MILTON (CEO)
(518) 243-4141
Entity
Organization
Contact information
Practice address
1101 NOTT ST, SCHENECTADY, NY 12308-2425
(518) 243-1916
(518) 243-1853
Mailing address
1101 NOTT ST, SCHENECTADY, NY 12308-2425
(518) 243-1916
(518) 243-1853
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4601001H
NY
207Q00000X
Family Medicine Physician
4601001H
NY
261QU0200X
Urgent Care Clinic/Center
4601001H
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI6804
RAILROAD MEDICARE
NY
01
—
GRJ575
CDPHP
—
01
—
GRP417056001
BLUE SHIELD OF NENY
—
Enumeration date
01/15/2008
Last updated
03/14/2018
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