Provider Demographics
NPI:1477708691
Name:CITI COACH NYC, INC
Entity Type:Organization
Organization Name:CITI COACH NYC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YEFIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOKSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-777-1277
Mailing Address - Street 1:551 GRAND ST RM 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4282
Mailing Address - Country:US
Mailing Address - Phone:212-777-1277
Mailing Address - Fax:212-674-1608
Practice Address - Street 1:551 GRAND ST RM 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4282
Practice Address - Country:US
Practice Address - Phone:212-777-1277
Practice Address - Fax:212-674-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB90663343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)