Provider Demographics
NPI:1184078891
Name:FLYJET911
Entity type:Organization
Organization Name:FLYJET911
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:844-538-9111
Mailing Address - Street 1:12010 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1228
Mailing Address - Country:US
Mailing Address - Phone:844-538-9111
Mailing Address - Fax:
Practice Address - Street 1:12010 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1228
Practice Address - Country:US
Practice Address - Phone:844-538-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport