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Individual

BRIGID KATHLEEN ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1030 REED AVENUE, SUITE 114, WYOMISSING, PA 19610-2029
(610) 376-7365
(610) 376-1320
Mailing address
1030 REED AVENUE, SUITE 114, WYOMISSING, PA 19610-2029
(610) 376-7365
(610) 376-1320

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT012854
PA
207RN0300X
Nephrology Physician
Primary
OS015324
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102933835-0001
PA
Enumeration date
06/12/2009
Last updated
10/01/2018
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