Provider Demographics
NPI:1760810899
Name:HOMETOWN TAXI INC.
Entity Type:Organization
Organization Name:HOMETOWN TAXI INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DAPARMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-287-5200
Mailing Address - Street 1:176 MARINER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-3479
Mailing Address - Country:US
Mailing Address - Phone:631-287-5200
Mailing Address - Fax:631-287-1477
Practice Address - Street 1:176 MARINER DR
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-3479
Practice Address - Country:US
Practice Address - Phone:631-287-5200
Practice Address - Fax:631-287-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02580207343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02580207Medicaid