Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA07702900 | NJ |
N | 207VG0400X | Gynecologist | 25MA07702900 | NJ |
N | 207VX0201X | Gynecologic Oncologist | 25MA07702900 | NJ |
NPI | 1609867100 |
---|---|
Provider Name | Dr. Ellen Louise Conner |
First Address | Neptune, NJ 07753-4488 |
Second Address | Neptune, NJ 07753-4488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 30/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0043214 | (05) | NJ |
H73278 | (02) | NJ |