Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 034180 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 034180 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 034180 | NY |
N | 2251P0200X | Physical Therapist - Pediatrics | 034180 | NY |
N | 2251S0007X | Physical Therapist - Sports | 034180 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 034180 | NY |
NPI | 1639412661 |
---|---|
Provider Name | Dr. Anthony P Ellis |
First Address | Brooklyn, NY 11231-5064 |
Second Address | Brooklyn, NY 11231-5064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 27/03/2013 |