| NPI | 1548740848 |
|---|---|
| Doing Business As | ELLIS PRIMARY CARE - GLENVILLE |
| Entity Type | Organization |
| Authorized Contact | PAUL A MILTON CEO 518-243-4175 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 4601001H) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |