Dr. Ellis Enabosi, MD
Internal Medicine in Staten Island, New York
1669866158- Practice location
- 455 Jersey St, Staten Island, NY 10301-2976
- Phone
- 187-524-5611
- Fax
- —
- Last updated
- January 8, 2021
Ellis Enabosi is an Internal Medicine based in Staten Island, NY. Ellis Enabosi practices in Staten Island, NY and has the professional credentials of MD. The NPI Number for Ellis Enabosi is 1669866158 and holds a License No. 291470 (NY). The current practice location address for Ellis Enabosi is 455 Jersey St, Staten Island, NY 10301-2976 and can be reached out via phone at 187-524-5611.
Provider Profile Details
- NPI Number
- 1669866158
- Provider Name
- Ellis Enabosi
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 455 Jersey St, Staten Island, NY 10301-2976
- Phone Number
- 187-524-5611
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 24, 2015
- Last Update Date
- January 8, 2021
- Certification Date
- January 8, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 455 Jersey St
Staten Island, NY 10301-2976 - City
- Staten Island
- State
- New York
- Zip
- 10301-2976
- Phone Number
- 187-524-5611
Provider Business Mailing Address Details
- Address
- 1434 Williamsbridge RD Fl 2
Bronx, NY 10461-2507 - City
- Bronx
- State
- NY
- Zip
- 10461-2507
- Phone Number
- 718-618-0401
- Fax Number
- 347-479-1303
License Information
- License Number (1)
- 291470
- License State (1)
- NY
- Taxonomy (1)
- General Practice · 208D00000X
- License Number (2)
- 291470
- License State (2)
- NY
- Taxonomy (2)
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Ellis Enabosi, MD?
The NPI number of Dr. Ellis Enabosi, MD is 1669866158. It was assigned on March 24, 2015 and is currently active in the NPPES registry.
What is the specialty of Dr. Ellis Enabosi, MD?
Dr. Ellis Enabosi, MD is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in NY under license number 291470.
Where does Dr. Ellis Enabosi, MD practice?
The practice location is 455 Jersey St, Staten Island, NY 10301-2976. The office can be reached at 187-524-5611 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1669866158 directly on the NPPES registry website.