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1992297394
ALISA RUTH ELLIS
MELVILLE, NY
NPI
1992297394
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: NY 449280)
Enumeration Date
2018-05-31
Last Update Date
2018-05-31
Business Address
ALISA RUTH ELLIS
2320 COURT NORTH DR
MELVILLE, NY 11747-8147
Phone number: 631-424-0842
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Mailing Address
ALISA RUTH ELLIS
2320 COURT NORTH DR
MELVILLE, NY 11747-8147
Phone number: 631-424-0842
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