Healthcare Provider Details

I. General information

NPI: 1285024026
Provider Name (Legal Business Name): IGOR ELMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2015
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 N MAIN ST
NEW CITY NY
10956-5302
US

IV. Provider business mailing address

226 N MAIN ST
NEW CITY NY
10956-5302
US

V. Phone/Fax

Practice location:
  • Phone: 845-362-1169
  • Fax: 845-362-0111
Mailing address:
  • Phone: 845-362-1169
  • Fax: 845-362-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number281770
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number281770
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25MB09777200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: