Healthcare Provider Details

I. General information

NPI: 1407515711
Provider Name (Legal Business Name): ELLIOTT FURMAN CRPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 MATTHEWS ST
GOSHEN NY
10924-1962
US

IV. Provider business mailing address

27 MATTHEWS ST
GOSHEN NY
10924-1962
US

V. Phone/Fax

Practice location:
  • Phone: 845-294-5888
  • Fax: 845-294-1469
Mailing address:
  • Phone: 845-281-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: