Provider Demographics
NPI:1710111992
Name:ELLIS, ROBERT ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ABRAHAM
Last Name:ELLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 98TH STREET
Mailing Address - Street 2:BOX 1188 -- MT. SINAI -- DEPARTMENT OF ORTHOPAEDICS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:773-350-7200
Mailing Address - Fax:
Practice Address - Street 1:5 E 98TH STREET
Practice Address - Street 2:MT. SINAI -- DEPARTMENT OF ORTHOPAEDICS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:773-350-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery