Provider Demographics
NPI:1558616953
Name:EZ RIDE ENTERPRISES NJ CORP
Entity Type:Organization
Organization Name:EZ RIDE ENTERPRISES NJ CORP
Other - Org Name:EZ RIDE AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPOSHNIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-582-6070
Mailing Address - Street 1:16 LAKE AVE
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1806
Mailing Address - Country:US
Mailing Address - Phone:917-582-6070
Mailing Address - Fax:
Practice Address - Street 1:16 LAKE AVE
Practice Address - Street 2:SUITE 5A
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1806
Practice Address - Country:US
Practice Address - Phone:917-582-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance