ELLIS MEDICAL CENTER LLC NPI 1740424969

NPI Information

NPI: 1740424969
Provider Name: ELLIS MEDICAL CENTER, LLC
Classification: Clinic/Center - 261QX0100X
Entity Type: Organization

Specialization: Occupational Medicine

Address:
701 COTTAGE GROVE RD
BLOOMFIELD, CT
ZIP 06002
Phone: (860) 243-1864
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ELLIS MEDICAL CENTER, LLC is an occupational medicine clinic center in Bloomfield, CT. ELLIS MEDICAL CENTER, LLC NPI is 1740424969. The provider is registered as an organization entity type.

The provider's business location address is:

701 COTTAGE GROVE RD
BLOOMFIELD, CT
ZIP 06002-080
Phone: (860) 243-1864

The provider's authorized official is Lenworth Ellis .
The authorized official title is Managing Member and has the following contact phone number (860) 243-1864.

The enumeration date for this NPI number is 5/1/2009 and was last updated on 5/1/2009.

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	261QX0100X	Clinic/Center	Occupational Medicine	041803	CONNECTICUT	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	I01435	MEDICARE UPIN

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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