Provider Demographics
NPI:1306034186
Name:ILOSKI, SUZANA (OWNER PRESIDENT)
Entity Type:Individual
Prefix:MS
First Name:SUZANA
Middle Name:
Last Name:ILOSKI
Suffix:
Gender:F
Credentials:OWNER PRESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 LANZA AVENUE
Mailing Address - Street 2:#1 ILOSKIS MEDICAL TRANSPORTATION
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026
Mailing Address - Country:US
Mailing Address - Phone:973-546-4976
Mailing Address - Fax:973-546-4976
Practice Address - Street 1:267 LANZA AVENUE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026
Practice Address - Country:US
Practice Address - Phone:973-546-4976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJILOSKI020341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance