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General NPI Number Information
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NPI Number | 1205982063
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Entity Type | Organization
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Legal Business Name | ELANT AT GOSHEN
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 46 HARRIMAN DR
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City | GOSHEN
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State | NY
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Zip | 10924-2410
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Country | US
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Telephone | 845-291-3759
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Fax | 845-291-3833
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Provider Business Mailing Address
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Address Line | 46 HARRIMAN DR
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City | GOSHEN
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State | NY
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Zip | 10924-2410
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Country | US
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Telephone | 845-291-3759
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Fax | 845-291-3833
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Authorized Official
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Title or Position | VP COMPTROLLER
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Name | MS. ANNMARIE COVONE
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Credential |
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Telephone | 845-291-3759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 9470L001
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License Number State | NY
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