Provider Demographics
NPI:1235665415
Name:PRITCHARD, CARINEL JR (DRIVER)
Entity Type:Individual
Prefix:MR
First Name:CARINEL
Middle Name:
Last Name:PRITCHARD
Suffix:JR
Gender:M
Credentials:DRIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 NICHOLS AVE # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-1814
Mailing Address - Country:US
Mailing Address - Phone:347-232-3793
Mailing Address - Fax:
Practice Address - Street 1:234 NICHOLS AVE # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1814
Practice Address - Country:US
Practice Address - Phone:347-232-3793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161932946347E00000X, 343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker
No344600000XTransportation ServicesTaxi