Healthcare Provider Details

I. General information

NPI: 1073659082
Provider Name (Legal Business Name): ELANT AT FISHKILL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ROBERT R KASIN WAY
BEACON NY
12508-1559
US

IV. Provider business mailing address

46 HARRIMAN DR
GOSHEN NY
10924-2410
US

V. Phone/Fax

Practice location:
  • Phone: 845-291-3700
  • Fax:
Mailing address:
  • Phone: 845-291-3759
  • Fax: 845-291-3833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1355300N
License Number StateNY

VIII. Authorized Official

Name: ANNMARIE COVONE
Title or Position: VP COMPTROLLER
Credential:
Phone: 845-291-3759