Provider Demographics
NPI:1255679593
Name:L-AL LIMOUSINE CORPORATION
Entity type:Organization
Organization Name:L-AL LIMOUSINE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF L-AL LIMO CORP
Authorized Official - Prefix:MR
Authorized Official - First Name:GERSHON
Authorized Official - Middle Name:
Authorized Official - Last Name:GIMELFARB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-382-3535
Mailing Address - Street 1:1504 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5217
Mailing Address - Country:US
Mailing Address - Phone:718-382-3535
Mailing Address - Fax:718-382-8942
Practice Address - Street 1:1504 ELM AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5217
Practice Address - Country:US
Practice Address - Phone:718-382-3535
Practice Address - Fax:718-382-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01912578Medicaid