Provider Demographics
NPI:1063636587
Name:ELITE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ELITE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PESSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-862-1300
Mailing Address - Street 1:131 MAIN ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7052
Mailing Address - Country:US
Mailing Address - Phone:201-862-1300
Mailing Address - Fax:201-837-2074
Practice Address - Street 1:591 SUMMIT AVE
Practice Address - Street 2:SUITE 316
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2714
Practice Address - Country:US
Practice Address - Phone:201-386-0500
Practice Address - Fax:201-386-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061832Medicaid