Mary Ellen King
Internist Geriatric Medicine
155 Crystal Run Rd
Middletown
, New York 10941-4028
Mary Ellen King
Internist Geriatric Medicine
155 Crystal Run Rd
Middletown
, New York 10941-4028
(845) 987-5979
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About
Features
Specialties
- Internist
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Mary Ellen King
- 20 Grand St Fl 3
- Warwick, NY
- Zip : 10990-1035
- Fax : (845) 987-5979
- Phone : (845) 856-3284
Second Address
- Mary Ellen King
- 155 Crystal Run Rd
- Middletown, NY
- Zip : 10941-4028
- Fax : (845) 703-6297
- Phone : (845) 703-6999
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 220224 | NY |
| Y | 111NI0900X | Internist | 220224 | NY |
| N | 207RG0300X | Geriatric Medicine | 220224 | NY |
National Provider Identifier
| NPI | 1124050497 |
|---|---|
| Provider Name | Mary Ellen King |
| First Address | Warwick, NY 10990-1035 |
| Second Address | Middletown, NY 10941-4028 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/07/2006 |
| Last Update Date | 05/09/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 02192372 | (05) | NY |
| H52251 | (02) | |
| MK0027SX20 | BCBS (01) | NY |
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.