Provider Demographics
NPI:1083805634
Name:NEW YORK AMBULETTE TRANSPORT INC
Entity Type:Organization
Organization Name:NEW YORK AMBULETTE TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-375-6603
Mailing Address - Street 1:262 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1810
Mailing Address - Country:US
Mailing Address - Phone:914-375-6603
Mailing Address - Fax:914-375-6606
Practice Address - Street 1:262 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1810
Practice Address - Country:US
Practice Address - Phone:914-375-6603
Practice Address - Fax:914-375-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31277343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02857587Medicaid