Provider Demographics
NPI:1891908125
Name:LSLAT INC
Entity Type:Organization
Organization Name:LSLAT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NUDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-236-7070
Mailing Address - Street 1:7410 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5703
Mailing Address - Country:US
Mailing Address - Phone:718-236-7070
Mailing Address - Fax:718-236-4544
Practice Address - Street 1:7410 20TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5703
Practice Address - Country:US
Practice Address - Phone:718-236-7070
Practice Address - Fax:718-236-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02730849Medicaid