Provider Demographics
NPI:1467432195
Name:GELB, ELLA (OD)
Entity Type:Individual
Prefix:DR
First Name:ELLA
Middle Name:
Last Name:GELB
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 1:3901 NOSTRAND AVE
Mailing Address - Street 2:APT.6P
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2150
Mailing Address - Country:US
Mailing Address - Phone:347-374-3167
Mailing Address - Fax:
Practice Address - Street 1:1419 SHEEPSHEAD BAY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3813
Practice Address - Country:US
Practice Address - Phone:718-934-1155
Practice Address - Fax:718-934-0770
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT006567152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02299136Medicaid
NYC217GCS141Medicare PIN
NYC217G1Medicare PIN
NYU92162Medicare UPIN