Provider Demographics
NPI:1821612680
Name:JETSET TRANSPORTATION CORP
Entity Type:Organization
Organization Name:JETSET TRANSPORTATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVELIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GALVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-249-1686
Mailing Address - Street 1:11835 QUEENS BLVD STE 400405
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7200
Mailing Address - Country:US
Mailing Address - Phone:347-566-7735
Mailing Address - Fax:
Practice Address - Street 1:11835 QUEENS BLVD STE 400405
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7200
Practice Address - Country:US
Practice Address - Phone:347-566-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05963800Medicaid