Provider Demographics
NPI:1801372933
Name:MJ AMBULETTE SERVICES INC.
Entity Type:Organization
Organization Name:MJ AMBULETTE SERVICES INC.
Other - Org Name:AN ORGANIZATION THAT RENDERS HEALTH CARE.NOT A SUBPART
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-721-5448
Mailing Address - Street 1:1071 MIRABELLE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5523
Mailing Address - Country:US
Mailing Address - Phone:516-248-2415
Mailing Address - Fax:516-248-2415
Practice Address - Street 1:1071 MIRABELLE AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5523
Practice Address - Country:US
Practice Address - Phone:516-248-2415
Practice Address - Fax:516-248-2415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)