Individual
NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2868 BELTAGH AVENUE, BELLMORE, NY 11710
(516) 639-4021
Mailing address
2868 BELTAGH AVENUE, BELLMORE, NY 11710
(516) 639-4021
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010386-01
NY
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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