Provider Demographics
NPI:1003523978
Name:CHRISTY, ELLEN ROSE (DNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:ROSE
Last Name:CHRISTY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N FAIRMOUNT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4907
Mailing Address - Country:US
Mailing Address - Phone:813-417-0725
Mailing Address - Fax:
Practice Address - Street 1:116 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-2960
Practice Address - Country:US
Practice Address - Phone:201-984-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00081000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology