Provider Demographics
NPI:1205345683
Name:CUTTLE BUG TAXI INC
Entity type:Organization
Organization Name:CUTTLE BUG TAXI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-928-9976
Mailing Address - Street 1:215 WEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-3532
Mailing Address - Country:US
Mailing Address - Phone:518-928-9976
Mailing Address - Fax:
Practice Address - Street 1:215 WEMPLE RD
Practice Address - Street 2:
Practice Address - City:GLENMONT
Practice Address - State:NY
Practice Address - Zip Code:12077-3532
Practice Address - Country:US
Practice Address - Phone:518-928-9976
Practice Address - Fax:518-928-9976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03560712Medicaid