Provider Demographics
NPI:1740619709
Name:MEDIAIDE LLC
Entity Type:Organization
Organization Name:MEDIAIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-698-5883
Mailing Address - Street 1:737 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12182-2204
Mailing Address - Country:US
Mailing Address - Phone:518-698-5883
Mailing Address - Fax:581-514-1177
Practice Address - Street 1:737 2ND AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12182-2204
Practice Address - Country:US
Practice Address - Phone:518-698-5883
Practice Address - Fax:581-514-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-10
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi