Individual
DR. DAVID A ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, MEDICAL IMAGING DEPARTMENT, ALBANY, NY 12208-1707
(518) 525-1852
(518) 525-1559
Mailing address
315 S MANNING BLVD, MEDICAL IMAGING DEPARTMENT, ALBANY, NY 12208-1707
(518) 525-1852
(518) 525-1559
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
144672
NY
2085R0202X
Diagnostic Radiology Physician
Primary
144672
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00797791
—
NY
Enumeration date
08/16/2005
Last updated
05/24/2012
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