Provider Demographics
NPI:1568740579
Name:GAZELA EXPRESS CORP
Entity Type:Organization
Organization Name:GAZELA EXPRESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-924-5404
Mailing Address - Street 1:318 21ST AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-3538
Mailing Address - Country:US
Mailing Address - Phone:718-924-5404
Mailing Address - Fax:
Practice Address - Street 1:318 21ST AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-3538
Practice Address - Country:US
Practice Address - Phone:718-924-5404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)