Individual
DAVID J ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
70 HATFIELD LN, STE 204, GOSHEN, NY 10924-6735
(845) 291-1260
(845) 294-2312
Mailing address
2 COATES DR, GOSHEN, NY 10924-6758
(845) 651-1400
(845) 651-1512
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
180343
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01852446
—
NY
01
—
18N881L663
MEDICARE
—
Enumeration date
06/30/2005
Last updated
09/27/2012
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