Provider Demographics
NPI:1861725582
Name:ELANT AT FISHKILL
Entity type:Organization
Organization Name:ELANT AT FISHKILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:845-831-8704
Mailing Address - Street 1:22 ROBERT R KASIN WAY
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1559
Mailing Address - Country:US
Mailing Address - Phone:845-831-8704
Mailing Address - Fax:845-831-1124
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:845-831-8704
Practice Address - Fax:845-831-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024881313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility