Provider Demographics
NPI:1184965394
Name:RANNETA TRANSPORTATION INC
Entity type:Organization
Organization Name:RANNETA TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:AYLYAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-985-8600
Mailing Address - Street 1:6269 99TH ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1841
Mailing Address - Country:US
Mailing Address - Phone:347-985-8600
Mailing Address - Fax:347-730-5656
Practice Address - Street 1:6269 99TH ST STE 2B
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1841
Practice Address - Country:US
Practice Address - Phone:347-985-8600
Practice Address - Fax:347-730-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30732343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02913758Medicaid