Individual
MRS. CRYSTAL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11 W PROSPECT AVE, MOUNT VERNON, NY 10550-2017
(914) 668-8938
(914) 668-2545
Mailing address
845 N BROADWAY, WHITE PLAINS, NY 10603-2427
(914) 761-0600
(914) 761-5367
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
344728
NY
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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