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General NPI Number Information
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NPI Number | 1700078086
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Entity Type | Individual
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Provider Name | ELAINA MOYSHELIS OD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 03/07/2018
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Provider Practice Location Address
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Address Line | 3929 BROADWAY OPTICA EXPRESS
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City | NEW YORK
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State | NY
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Zip | 10032-1538
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Country | US
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Telephone | 212-568-4693
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Fax | 212-568-4694
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Provider Business Mailing Address
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Address Line | FAMILY EYECARE LLC 515 N WOOD AVE STE 102
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City | LINDEN
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State | NJ
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Zip | 07036-4173
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Country | US
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Telephone | 908-259-5059
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Fax | 908-486-5006
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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 | 007206
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License Number State | NY
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