MEDICARE: MS. DONNA LYNN ELKIN LCSWR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	R0344411	NY

General Provider Information

NPI Number	:	1265598825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DONNA LYNN ELKIN LCSWR

Provider Business Mailing Address
First Line	:	14 STONEHEDGE AVE
Second Line	:
City	:	NEW PALTZ
State	:	NY
Zip	:	12561-3126
Country	:	US
Telephone Number	:	845-255-4343
Fax Number	:	877-224-9708

Provider Business Practice Location Address
First Line	:	372 FULLERTON AVE
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-3744
Country	:	US
Telephone Number	:	845-255-4343
Fax Number	:	877-224-9708

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	05/25/2018

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