Individual
MRS. EWA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
180A GROVE AVE, PATCHOGUE, NY 11772-4134
(631) 697-8613
Mailing address
180A GROVE AVE, PATCHOGUE, NY 11772-4134
(631) 697-8613
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
03522-1
NY
Other
Enumeration date
01/09/2011
Last updated
01/09/2011
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