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Contact Information

MARY K ELLIS, MD
196 MERRICK RD
OCEANSIDE, NY11572-1420
 Phone: 516-255-8400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MARY K ELLIS · (Female)

NPI # 1134447329
Status Active
Credentials MD
Entity Individual
Enumeration date 05/12/2010
Last updated 12/06/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME116438
  • NY License # 277569
Hospital affiliation(s)
  • SOUTH NASSAU COMMUNITIES HOSPITAL - (Acute Care)
    ONE HEALTHY WAY
    OCEANSIDE, NY 11572
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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