Provider Demographics
NPI:1326115809
Name:JP AMBULETTE CORPORATION
Entity Type:Organization
Organization Name:JP AMBULETTE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:PEPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-274-7402
Mailing Address - Street 1:19 58 81ST STREET
Mailing Address - Street 2:PRIVATE HOUSE
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1320
Mailing Address - Country:US
Mailing Address - Phone:718-274-7402
Mailing Address - Fax:718-274-7534
Practice Address - Street 1:1958 81ST ST
Practice Address - Street 2:PRIVATE HOUSE
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1320
Practice Address - Country:US
Practice Address - Phone:718-274-7402
Practice Address - Fax:718-274-7534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
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
NY01052831Medicaid