Individual provider · Type 1 NPI
Nicole Danielle Ellenbogen
Medical Physician Assistant · New York, NY
NPI number
1174369201
Active
Practice location
100 E 77th St
New York, NY 10075-1850
Mailing address
761 Downing St
Teaneck, NJ 07666-2221
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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About NPI 1174369201
Nicole Danielle Ellenbogen's National Provider Identifier is 1174369201, issued on Jul 8, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New York, NY. The record was last updated on Jul 15, 2024.