Provider Demographics
NPI:1013557016
Name:LAN TIAN CAR SERVICE INC
Entity Type:Organization
Organization Name:LAN TIAN CAR SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PIQI
Authorized Official - Middle Name:
Authorized Official - Last Name:DU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-661-2666
Mailing Address - Street 1:3370 PRINCE ST STE 606
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2703
Mailing Address - Country:US
Mailing Address - Phone:718-661-2666
Mailing Address - Fax:
Practice Address - Street 1:3370 PRINCE ST STE 606
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2703
Practice Address - Country:US
Practice Address - Phone:718-661-2666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05451267Medicaid