Individual
DR. RITA ELLENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
8325 37TH AVE, JACKSON HEIGHTS, NY 11372-7320
(718) 426-2725
Mailing address
12 STATION SQ, FOREST HILLS, NY 11375-5234
(917) 803-0002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT005856
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02287781
—
NY
01
—
49890
DAVIS
NY
Enumeration date
07/11/2005
Last updated
07/17/2013
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