Provider Demographics
NPI:1700078086
Name:MOYSHELIS, ELAINA (OD)
Entity Type:Individual
Prefix:DR
First Name:ELAINA
Middle Name:
Last Name:MOYSHELIS
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:FAMILY EYECARE LLC
Mailing Address - Street 2:515 N WOOD AVE STE 102
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4173
Mailing Address - Country:US
Mailing Address - Phone:908-259-5059
Mailing Address - Fax:908-486-5006
Practice Address - Street 1:3929 BROADWAY
Practice Address - Street 2:OPTICA EXPRESS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1538
Practice Address - Country:US
Practice Address - Phone:212-568-4693
Practice Address - Fax:212-568-4694
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007206152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist