Individual
DR. GRANT ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53 W 23RD ST FL 6, NEW YORK, NY 10010-4237
(212) 746-7204
(212) 746-7203
Mailing address
53 W 23RD ST FL 6, NEW YORK, NY 10010-4237
(212) 746-7204
(212) 746-7203
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
291619
NY
Other
Enumeration date
03/22/2012
Last updated
03/13/2018
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