Provider Demographics
NPI:1437510245
Name:BROAD DYCKMAN CAR SERVICE, INC
Entity Type:Organization
Organization Name:BROAD DYCKMAN CAR SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUNO
Authorized Official - Middle Name:D
Authorized Official - Last Name:GENAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-304-0902
Mailing Address - Street 1:203 DYCKMAN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-1068
Mailing Address - Country:US
Mailing Address - Phone:212-304-0902
Mailing Address - Fax:
Practice Address - Street 1:203 DYCKMAN ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1068
Practice Address - Country:US
Practice Address - Phone:212-304-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB01083344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi