Provider Demographics
NPI:1811193626
Name:MR TRANSPORTATION INC
Entity Type:Organization
Organization Name:MR TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:YEGUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-569-2400
Mailing Address - Street 1:407 CENTRAL AVE
Mailing Address - Street 2:SEC FL
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1906
Mailing Address - Country:US
Mailing Address - Phone:516-569-2400
Mailing Address - Fax:
Practice Address - Street 1:407 CENTRAL AVE
Practice Address - Street 2:SEC FL
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1906
Practice Address - Country:US
Practice Address - Phone:516-569-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02877425Medicaid