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Contact Information

ELLIS B CHARLES, MD
90 WASHINGTON ST
EAST ORANGE, NJ07017-1050
 Phone: 973-672-2555
 Fax: 973-672-2529
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for ELLIS B CHARLES · (Male)

NPI Number 1013046341
Status Active
Credentials MD
Entity Individual
Enumeration date 03/04/2007
Last updated 03/05/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 18284
  • NJ License # 25MA05127300
  • NY License # 132910
  • NJ Medicaid 0866300
Hospital affiliation(s)
  • EAST ORANGE GENERAL HOSPITAL - (Acute Care)
    300 CENTRAL AVE
    EAST ORANGE, NJ 07018
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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