Provider Demographics
NPI:1073659082
Name:ELANT AT FISHKILL, INC.
Entity Type:Organization
Organization Name:ELANT AT FISHKILL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP COMPTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COVONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-291-3759
Mailing Address - Street 1:46 HARRIMAN DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2410
Mailing Address - Country:US
Mailing Address - Phone:845-291-3759
Mailing Address - Fax:845-291-3833
Practice Address - Street 1:22 ROBERT R KASIN WAY
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-1559
Practice Address - Country:US
Practice Address - Phone:845-291-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1355300N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00308636Medicaid
NY00308636Medicaid