Provider Demographics
NPI:1003265372
Name:AMSTERDAM EXPRESS
Entity Type:Organization
Organization Name:AMSTERDAM EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JANJUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-669-5980
Mailing Address - Street 1:4303 STATE HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-4275
Mailing Address - Country:US
Mailing Address - Phone:518-669-5980
Mailing Address - Fax:
Practice Address - Street 1:4303 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4275
Practice Address - Country:US
Practice Address - Phone:518-669-5980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03443441Medicaid