| NPI | 1104424621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT JACOB ELLIS President 646-797-8305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |