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Individual

SCOTT RYAN ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(917) 747-8487
Mailing address
7901 BROADWAY, ELMHURST, NY 11373-1329

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
324008
NY

Other

Enumeration date
03/31/2016
Last updated
06/11/2025
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