Provider Demographics
NPI:1598188815
Name:UNITED TRANSPORTATION AMBULETTE INCORPORATION
Entity Type:Organization
Organization Name:UNITED TRANSPORTATION AMBULETTE INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVGENY
Authorized Official - Middle Name:
Authorized Official - Last Name:OVSYANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-373-5588
Mailing Address - Street 1:1660 E 21ST ST
Mailing Address - Street 2:6F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5050
Mailing Address - Country:US
Mailing Address - Phone:917-373-5588
Mailing Address - Fax:
Practice Address - Street 1:1660 E 21ST ST
Practice Address - Street 2:6F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5050
Practice Address - Country:US
Practice Address - Phone:917-373-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY837566229343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)