Provider Demographics
NPI:1205258274
Name:ECO RIDE INC
Entity type:Organization
Organization Name:ECO RIDE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIKTORIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILYADOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-252-5555
Mailing Address - Street 1:6002 FOSTER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3103
Mailing Address - Country:US
Mailing Address - Phone:718-252-5555
Mailing Address - Fax:718-646-0600
Practice Address - Street 1:6002 FOSTER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3103
Practice Address - Country:US
Practice Address - Phone:718-252-5555
Practice Address - Fax:718-646-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB02687344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB02687OtherNYC TLC
NYPENDINGMedicaid