Individual
ELLEN BLYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
123 W 86TH ST, NEW YORK, NY 10024-3419
(212) 877-2833
(212) 362-7080
Mailing address
123 W 86TH ST, NEW YORK, NY 10024-3419
(212) 877-2833
(212) 362-7080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
141907
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00867976
—
NY
Enumeration date
11/08/2006
Last updated
08/30/2020
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