DR. ENRIQUE ELLENBOGEN M.D. NPI 1972671709

NPI Information

NPI: 1972671709
Provider Name: DR. ENRIQUE ELLENBOGEN, M.D.
Classification: Ophthalmology - 207W00000X
Entity Type: Individual
Address:
700 S STANFIELD RD
SUITE B
TROY, OH
ZIP 45373
Phone: (937) 335-7121
Get Directions

DR. Enrique Ellenbogen, M.D. is an ophthalmology in Troy, OH. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. DR. Enrique Ellenbogen, M.D. NPI is 1972671709. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

700 S STANFIELD RD
SUITE B
TROY, OH
ZIP 45373-569
Phone: (937) 335-7121
Fax: (937) 335-7124

The enumeration date for this NPI number is 12/1/2006 and was last updated on 1/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207W00000X	Ophthalmology		35100246	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A75323	MEDICARE UPIN
2	000000010310	OTHER		ANTHEM
3	0411763	MEDICARE ID-TYPE UNSPECIFIED
4	L0277598	MEDICAID	OHIO
5	311024334	OTHER	OHIO	TAX IDENTIFICATION NUMBER
6	D00246	OTHER		HUMANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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