Provider Demographics
NPI: | 1295367647 |
---|---|
Name: | ALLMEDICAL AMBULETTE INC. |
Entity Type: | Organization |
Organization Name: | ALLMEDICAL AMBULETTE INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | SHIA |
Authorized Official - Middle Name: | W |
Authorized Official - Last Name: | GREENFELD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 718-407-4151 |
Mailing Address - Street 1: | 165 FRANKLIN AVE APT 8 |
Mailing Address - Street 2: | |
Mailing Address - City: | BROOKLYN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11205-2760 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-407-4151 |
Mailing Address - Fax: | 917-591-8404 |
Practice Address - Street 1: | 777 KENT AVE STE 239A |
Practice Address - Street 2: | |
Practice Address - City: | BROOKLYN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11205-1588 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-407-4151 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-02-04 |
Last Update Date: | 2020-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 02754314 | Medicaid |