Provider Demographics
NPI:1639239932
Name:JESSICA LIBERMAN
Entity Type:Organization
Organization Name:JESSICA LIBERMAN
Other - Org Name:JYL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-532-0831
Mailing Address - Street 1:64 MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-2140
Mailing Address - Country:US
Mailing Address - Phone:508-532-0831
Mailing Address - Fax:508-532-0513
Practice Address - Street 1:64 MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:SPENCER
Practice Address - State:MA
Practice Address - Zip Code:01562-2140
Practice Address - Country:US
Practice Address - Phone:508-532-0831
Practice Address - Fax:508-532-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-10
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)