Provider Demographics
NPI:1225277478
Name:MARLBORO CAR SERVICE INC
Entity Type:Organization
Organization Name:MARLBORO CAR SERVICE INC
Other - Org Name:AHSAN INC DBA MARLBORO CAR SERVICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARKHIPOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-229-0000
Mailing Address - Street 1:2615 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5501
Mailing Address - Country:US
Mailing Address - Phone:347-229-0000
Mailing Address - Fax:718-434-2166
Practice Address - Street 1:275 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1346
Practice Address - Country:US
Practice Address - Phone:347-229-0000
Practice Address - Fax:718-434-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB00987344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03059978Medicaid