Provider Demographics
NPI:1235753666
Name:ELIAV HEALTHCARE LLC
Entity Type:Organization
Organization Name:ELIAV HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:UZHANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:215-390-2066
Mailing Address - Street 1:1969 AMBASSADOR ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4635
Mailing Address - Country:US
Mailing Address - Phone:215-390-2066
Mailing Address - Fax:215-402-1000
Practice Address - Street 1:1123 N 63RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-3209
Practice Address - Country:US
Practice Address - Phone:215-390-2066
Practice Address - Fax:215-402-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health