Jeffrey M Ellenbogen
Neurologist
55 Fruit Street Wang 720 (neurology)
Boston
, Massachusetts 02114
Jeffrey M Ellenbogen
Neurologist
55 Fruit Street Wang 720 (neurology)
Boston
, Massachusetts 02114
(617) 724-7419
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Jeffrey M Ellenbogen
- 60 White Oak Rd
- Newton, MA
- Zip : 02468-1323
- Phone : (617) 724-7419
Second Address
- Jeffrey M Ellenbogen
- 55 Fruit Street Wang 720 (neurology)
- Boston, MA
- Zip : 02114
- Phone : (617) 724-7419
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 226436 | MA |
National Provider Identifier
| NPI | 1003856535 |
|---|---|
| Provider Name | Jeffrey M Ellenbogen |
| First Address | Newton, MA 02468-1323 |
| Second Address | Boston, MA 02114 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/06/2006 |
| Last Update Date | 16/11/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.