Healthcare Provider Details

I. General information

NPI: 1265314603
Provider Name (Legal Business Name): ELEVATE HOME PT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 WOODLANDS DR
TUXEDO PARK NY
10987-4819
US

IV. Provider business mailing address

228 NY-17 #19
TUXEDO PARK NY
10987
US

V. Phone/Fax

Practice location:
  • Phone: 845-671-0571
  • Fax:
Mailing address:
  • Phone: 845-671-0571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. EVAN KUGEL
Title or Position: OWNER
Credential: DPT
Phone: 845-671-0571