Healthcare Provider Details

I. General information

NPI: 1982101614
Provider Name (Legal Business Name): ELTON LLUKANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 05/14/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

IV. Provider business mailing address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

V. Phone/Fax

Practice location:
  • Phone: 845-333-3370
  • Fax: 845-333-3372
Mailing address:
  • Phone: 845-333-3370
  • Fax: 845-333-3372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number312086
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: