Provider Demographics
NPI:1174894554
Name:NEYLON, ELLEN ANN (NP)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:ANN
Last Name:NEYLON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 EAST 60TH STREET
Mailing Address - Street 2:SUITE 330
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1096
Mailing Address - Country:US
Mailing Address - Phone:212-326-5720
Mailing Address - Fax:
Practice Address - Street 1:16 E 60TH ST
Practice Address - Street 2:SUITE 330
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1096
Practice Address - Country:US
Practice Address - Phone:212-326-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF 336680364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology