Provider Demographics
NPI:1639883192
Name:ELBERT, RIMMA
Entity Type:Individual
Prefix:
First Name:RIMMA
Middle Name:
Last Name:ELBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3202
Mailing Address - Country:US
Mailing Address - Phone:917-502-8771
Mailing Address - Fax:
Practice Address - Street 1:8 ASHLEY CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3202
Practice Address - Country:US
Practice Address - Phone:917-502-8771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier