Provider Demographics
NPI:1285846519
Name:DOLPHIN MEDICAL TRANSPORTATION INC
Entity Type:Organization
Organization Name:DOLPHIN MEDICAL TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:DIKSHTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-234-2207
Mailing Address - Street 1:104 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6504
Mailing Address - Country:US
Mailing Address - Phone:718-234-2207
Mailing Address - Fax:718-234-7554
Practice Address - Street 1:104 AVENUE O
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6504
Practice Address - Country:US
Practice Address - Phone:718-234-2207
Practice Address - Fax:718-234-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01882553Medicaid