Most Relevant Information
Provider Data
| NPI Number: | 1003398041 |
| Provider Name: | ELLEN DUBNER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 1268621 |
Most Important Dates
| Enumeration Date: | 09/06/2018 |
| Last Updated: | 09/06/2018 |
Provider Practice Location
2817 W 12TH ST
BROOKLYN
NY
112243101
Practice Location Phone/Fax
| Phone: | 9174141890 |
| Fax: |
Provider Mailing Location
384 FREEBORN ST
STATEN ISLAND
NY
103065840
Provider Mailing Phone/Fax
| Phone: | 9174141890 |
| Fax: |