Healthcare Provider Details

I. General information

NPI: 1235276981
Provider Name (Legal Business Name): ELANT AT FISHKILL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 S MESIER AVENUE
WAPPINGER FALLS NY
12590-2718
US

IV. Provider business mailing address

46 HARRIMAN DRIVE
GOSHEN NY
10924-2410
US

V. Phone/Fax

Practice location:
  • Phone: 845-360-1200
  • Fax: 845-291-3833
Mailing address:
  • Phone: 845-360-1200
  • Fax: 845-291-3833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1324301N
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1324302N
License Number StateNY

VIII. Authorized Official

Name: MR. TODD A. WHITNEY
Title or Position: PRESIDENT
Credential:
Phone: 845-360-1361