Provider Demographics
NPI:1396192555
Name:CARMEL TAXI AND CAR SERVICE INC.
Entity Type:Organization
Organization Name:CARMEL TAXI AND CAR SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANGELINA
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-225-5555
Mailing Address - Street 1:102 ROOT AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2034
Mailing Address - Country:US
Mailing Address - Phone:845-225-5555
Mailing Address - Fax:845-279-4400
Practice Address - Street 1:102 ROOT AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2034
Practice Address - Country:US
Practice Address - Phone:845-225-5555
Practice Address - Fax:845-279-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000000000344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02879725Medicaid