| NPI | 1265294201 |
|---|---|
| Doing Business As | ELLIS MEDICINE UROLOGY |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ANN WICKS Manager Accounts Receivable 518-382-2313 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-01-25 |