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Individual

DR. JASON A. ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
130 EAST 77TH STREET, DEPT. OF NEUROSURGERY, BLACK HALL, THIRD FLOOR, NEW YORK, NY 10075
(212) 434-3900
(212) 434-3899
Mailing address
130 EAST 77TH STREET, DEPT. OF NEUROSURGERY, BLACK HALL, THIRD FLOOR, NEW YORK, NY 10075
(212) 434-3900
(212) 434-3899

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
260313-1
NY
207T00000X
Neurological Surgery Physician
75452
GA

Other

Enumeration date
05/07/2008
Last updated
07/21/2022
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