Organization · Type 2 NPI

Ellis Hospital

Primary Care Clinic/Center · Glenville, NY

NPI number 1548740848 Active

Practice location

115 Saratoga Rd Ste 200
Glenville, NY 12302-4224

Specialties and licenses

Taxonomy	Code	License
Primary Care Clinic/Center Primary	261QP2300X	4601001H (NY)

Primary Care Clinic/Center: Definition to come...

3 other providers at this address

NPI record

NPI: 1548740848
Entity type: Organization (Type 2)
Issued: Aug 16, 2018
Last updated: Aug 16, 2018
Status: Active
Subpart: Yes of Ellis Hospital

Other names

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Ellis Primary Care - Glenville · doing business as
Ellis Primary Care - Glenville · doing business as

Authorized official

Paul A Milton
CEO
(518) 243-4175

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1548740848

Ellis Hospital's National Provider Identifier is 1548740848, issued on Aug 16, 2018. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Glenville, NY. The record was last updated on Aug 16, 2018.