Provider Demographics
NPI:1619313434
Name:OYSTER RIDES, LLC
Entity Type:Organization
Organization Name:OYSTER RIDES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-774-5657
Mailing Address - Street 1:99 PINE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-4703
Mailing Address - Country:US
Mailing Address - Phone:631-774-5657
Mailing Address - Fax:516-624-2873
Practice Address - Street 1:99 PINE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771
Practice Address - Country:US
Practice Address - Phone:631-774-5657
Practice Address - Fax:516-624-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0353850Medicaid