Provider Demographics
NPI:1336596014
Name:T-P OF NEW YORK INC
Entity Type:Organization
Organization Name:T-P OF NEW YORK INC
Other - Org Name:CIRCLE OF LIFE AMBULETTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-538-9681
Mailing Address - Street 1:255 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:NY
Mailing Address - Zip Code:13788-3001
Mailing Address - Country:US
Mailing Address - Phone:607-538-9681
Mailing Address - Fax:607-538-9681
Practice Address - Street 1:255 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:NY
Practice Address - Zip Code:13788-3001
Practice Address - Country:US
Practice Address - Phone:607-538-9681
Practice Address - Fax:607-538-9681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32940343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03306172Medicaid