Provider Demographics
NPI:1831380179
Name:BRIGHT-ELLINGTON, VIRGIE (MD)
Entity type:Individual
Prefix:
First Name:VIRGIE
Middle Name:
Last Name:BRIGHT-ELLINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W 118TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-1809
Mailing Address - Country:US
Mailing Address - Phone:212-932-1911
Mailing Address - Fax:212-832-3133
Practice Address - Street 1:110 W 118TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-1809
Practice Address - Country:US
Practice Address - Phone:212-932-1911
Practice Address - Fax:212-832-3133
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine