Provider Demographics
NPI:1376797613
Name:DIANE TRANSPORTATION INC
Entity Type:Organization
Organization Name:DIANE TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARKADY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-544-4414
Mailing Address - Street 1:73-18 YELLOWSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4195
Mailing Address - Country:US
Mailing Address - Phone:718-544-4414
Mailing Address - Fax:718-544-4424
Practice Address - Street 1:73-18 YELLOWSTONE BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4195
Practice Address - Country:US
Practice Address - Phone:718-544-4414
Practice Address - Fax:718-544-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB90657343900000X
NYB90692343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03025261Medicaid