Provider Demographics
NPI:1619284569
Name:ELTON, ANNE (MSPT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:ELTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:RELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:152 HALGREN CRES
Mailing Address - Street 2:
Mailing Address - City:HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10927-1070
Mailing Address - Country:US
Mailing Address - Phone:845-461-5270
Mailing Address - Fax:
Practice Address - Street 1:152 HALGREN CRES
Practice Address - Street 2:
Practice Address - City:HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10927-1070
Practice Address - Country:US
Practice Address - Phone:845-461-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0250272251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics