Provider Demographics
NPI:1659757938
Name:SLK TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SLK TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHEROVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-513-4090
Mailing Address - Street 1:3405 NEPTUNE AVE
Mailing Address - Street 2:1141
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1673
Mailing Address - Country:US
Mailing Address - Phone:845-513-4090
Mailing Address - Fax:845-513-4091
Practice Address - Street 1:155 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SMALLWOOD
Practice Address - State:NY
Practice Address - Zip Code:12778
Practice Address - Country:US
Practice Address - Phone:845-513-4090
Practice Address - Fax:845-513-4091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY39183343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04060519Medicaid