Provider Demographics
NPI:1073286852
Name:SEHREMELIS, ELENI (OD)
Entity Type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:SEHREMELIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11376 BASKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2928
Mailing Address - Country:US
Mailing Address - Phone:562-881-6612
Mailing Address - Fax:
Practice Address - Street 1:185 MADISON AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0069
Practice Address - Country:US
Practice Address - Phone:212-689-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009426152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist