Healthcare Provider Details

I. General information

NPI: 1902165194
Provider Name (Legal Business Name): ELDERCHOICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 WEST MAIN STREET
ELBRIDGE NY
13060
US

IV. Provider business mailing address

208 WEST MAIN STREET
ELBRIDGE NY
13060
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-7889
  • Fax: 315-252-0453
Mailing address:
  • Phone: 315-252-7889
  • Fax: 315-252-0453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1603L001
License Number StateNY

VIII. Authorized Official

Name: MR. AARON HARRIS
Title or Position: VICE PRESIDENT
Credential:
Phone: 315-952-0341