Provider Demographics
NPI:1306198452
Name:ELENA L. MONKS, OD INC.
Entity Type:Organization
Organization Name:ELENA L. MONKS, OD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:LASKOVA
Authorized Official - Last Name:MONKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-983-3783
Mailing Address - Street 1:4 ALANA DR
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-3443
Mailing Address - Country:US
Mailing Address - Phone:201-983-3783
Mailing Address - Fax:973-949-3767
Practice Address - Street 1:35 PARK AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1711
Practice Address - Country:US
Practice Address - Phone:201-728-9399
Practice Address - Fax:201-728-9454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00621000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty