Provider Demographics
NPI:1679858765
Name:PINTO, ELLEN IDA (RPH)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:IDA
Last Name:PINTO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:IDA
Other - Last Name:RUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 W MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-2446
Mailing Address - Country:US
Mailing Address - Phone:914-592-0624
Mailing Address - Fax:800-395-6149
Practice Address - Street 1:200 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1523
Practice Address - Country:US
Practice Address - Phone:914-747-1150
Practice Address - Fax:914-747-1170
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist