Individual
TREVOR ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
15 REMINGTON CIR, WEST WINDSOR, NJ 08550-2922
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
319708
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2017
Last updated
10/13/2022
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