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General NPI Number Information
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NPI Number | 1306114020
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Entity Type | Individual
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Provider Name | ELIZABETH ANN SALL O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 2123 71ST ST 3R
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1000
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Country | US
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Telephone | 504-323-4757
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Fax |
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Provider Business Mailing Address
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Address Line | 2123 71ST ST 3R
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1000
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Country | US
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Telephone | 504-323-4757
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6097
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3850
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV008538
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2786
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG004197
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00671800
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License Number State | NJ
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