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Individual

CHARLES C ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 GUSTAVE L LEVY PL, ANESTHESIOLOGY - BOX 1010, NEW YORK, NY 10029-6500
(800) 627-4470
(412) 937-5710
Mailing address
PO BOX 5024, NEW YORK, NY 10087-5024
(800) 627-4470
(800) 627-4470

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
243685
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02890155
NY
Enumeration date
05/29/2007
Last updated
07/24/2013
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