Organization
ELIM HEALTHCARE SERVICES, P.T.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUROJAIYE SHADRACH OJETAYO P.T. (PRESIDENT)
(718) 776-3129
Entity
Organization
Contact information
Practice address
19621 HILLSIDE AVE, HOLLIS, NY 11423-2124
(718) 776-3129
(718) 776-3224
Mailing address
787 N ASCAN ST, ELMONT, NY 11003-4621
(516) 561-3922
(718) 776-3224
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
014849-1
NY
261QP2000X
Physical Therapy Clinic/Center
Primary
014849-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02778581
—
NY
01
—
OD4849
HEALTH PLAN
NY
Enumeration date
07/30/2006
Last updated
03/22/2017
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