Individual
DAVID ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22317 57TH AVE, OAKLAND GARDENS, NY 11364-2041
(718) 316-3589
Mailing address
22317 57TH AVE, OAKLAND GARDENS, NY 11364-2041
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
064475
NY
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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