Provider Demographics
NPI:1053337311
Name:HAIG, ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:HAIG
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 1:2 LINCOLN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5775
Mailing Address - Country:US
Mailing Address - Phone:516-536-0600
Mailing Address - Fax:516-536-0694
Practice Address - Street 1:2 LINCOLN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5775
Practice Address - Country:US
Practice Address - Phone:516-536-0600
Practice Address - Fax:516-536-0694
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176974-1207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAP512OtherOXFORD HEALTH PLANS
NY110106812OtherRAILROAD MEDICARE
NY1478104OtherUNITED HEALTHCARE
NY03G512OtherEMPIRE BCBS
NY03G512OtherEMPIRE BCBS