person
John M Ellis, MD
Diagnostic Radiology Physician in Utica, New York
NPI 1962464818

John M Ellis is a Diagnostic Radiology Physician based in Utica, NY and is specialized in Diagnostic Radiology. John M Ellis practices in Utica, NY and has the professional credentials of MD. The NPI Number for John M Ellis is 1962464818 and holds a License No. 209356 (New York).

The current practice location address for John M Ellis is 1656 Champlin Ave, Utica, NY and can be reached out via phone at 315-624-6116. You can also correspond with John M Ellis through the mailing address at 185 GENESEE ST, UTICA, NY - 13501-2199 (mailing address contact number: 315-793-8806).

Location: 1656 Champlin Ave, Utica, NY, 13501-2199
person
Provider Profile Details
NPI Number
1962464818
Provider Name
John M Ellis
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1656 Champlin Ave, Utica, NY, 13501-2199
Phone Number
315-624-6116
Fax Number
Provider Enumeration Date
04/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P010209356 01 NY BCBS
300099765 01 NY RAIL ROAD MEDICARE
01874611 05 NY
4199650 01 NY GHI
040426013962 01 NY FIDELIS
960976 01 NY MVP
209356-1 01 NY WC
10037625 01 NY CDPHP
institution
Provider Business Practice Location Address Details
Address
1656 Champlin Ave
City
State
Zip
13502-4830
Phone Number
315-624-6116
Fax Number
person
Provider Business Mailing Address Details
Address
185 Genesee St
City
State
Zip
13501-2199
Phone Number
315-793-8806
Fax Number
315-793-8046
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
209356 (New York)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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