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1003856535
JEFFREY M ELLENBOGEN
BOSTON, MA
NPI
1003856535
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084N0400X Psychiatry & Neurology, Neurology
(Licence: MA 226436)
Enumeration Date
2006-06-06
Last Update Date
2012-11-16
Business Address
-- JEFFREY M ELLENBOGEN M.D.
55 FRUIT STREET WANG 720 (NEUROLOGY)
BOSTON, MA 02114
Phone number: 617-724-7419
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Mailing Address
-- JEFFREY M ELLENBOGEN M.D.
60 WHITE OAK RD
NEWTON, MA 02468-1323
Phone number: 617-724-7419
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